Comparing Left Ventricular Structure and Functions in End-Stage Renal Disease Using Conventional Echocardiography and 2D Speckle Tracking Echocardiography.

BACKGROUND: Patients on hemodialysis (HD) are prone to various cardiovascular complications. Two-dimensional speckle tracking echocardiography (2D STE) is an innovative technique for early myocardial dysfunction detection, even with normal ejection fraction (EF). OBJECTIVE: We aim to detect left ventricle (LV) dysfunction in regular hemodialysis patients using 2D STE compared to traditional echocardiography. METHODS: The study comprised 30 patients with end-stage renal disease (ESRD), subdivided according to left ventricular mass index (LVMI) into group 1 with left ventricular hypertrophy (LVH) (n=19) and group 2 without LVH (n=11). Another 30 healthy control subjects were recruited as group 3. The EF, average systolic velocity (Sa), and 2D LV strain were taken as measures of LV systolic function. The indicators for diastolic function included the E/A ratio and E velocity/peak early diastolic velocity. RESULTS: Regarding the parameters of LV systolic and diastolic functions assessed by traditional echocardiography, we found no significant difference between groups 1 and 2. However, using 2D STE, we observed significant differences in the average Sa velocity (p=0.025), average LV strain (p=0.03), 2D global longitudinal strain (GLS) (p=0.03), E/Ea (p=0.003), and LV myocardial performance index (MPI) (p=0.006). Also, a significant positive correlation was found between LVMI and left ventricular end-diastolic diameter (LVEDD) (p<0.01, r=0.63), EF measured by 2D (p=0.034, r=0.39), mitral E/A ratio (p=0.03, r=0.49), and mitral E/Ea (p<0.01, r=0.72). There was a significantly strong negative correlation between LVMI and 2D average LV strain (p=0.034, r=-0.39). CONCLUSION: We concluded that 2D STE is more sensitive than a conventional echo in detecting early LV systolic and diastolic dysfunction even in patients with normal EF.

Histopathological Profile of Different Breast Lesions: A Single-Center Observational Study.

OBJECTIVE: To describe the histopathological pattern of different breast lesions among tissue specimens sent to our laboratory. METHOD: A record-based study using a retrospective review of 255 histologically diagnosed breast biopsy reports in the histopathology department of authors from December 2016 to November 2021 was conducted. The specimens were collected from core biopsy, lumpectomy, and mastectomy. All data obtained were analyzed using the Statistical Package for the Social Sciences (SPSS) version 28 (IBM SPSS Statistics, Armonk, NY). Then, the findings were presented using text, tables, and charts. RESULT: A total of 255 breast lesions were analyzed in this study. Most of the cases were benign (58.8%), followed by inflammatory lesions (21.6%), and malignant (19.6%). Fibroadenoma was the most prevalent benign lesion (36.7%), and most of the patients (70.9%) were in the age group of 20-39 years old. The most common inflammatory lesion was granulomatous mastitis (56.4%), and most of the cases were diagnosed in the age group of 30-39 years old. Invasive ductal carcinoma (IDC) was the most encountered histological type of carcinoma (62%). Of the malignant cases, 52% were diagnosed before the age of 50 years. Among these 50 cases, grade 2 was the most prevalent one (46%). CONCLUSION: Benign breast lesions are more common than malignant breast lesions, and fibroadenoma is the most common benign subtype. Granulomatous mastitis is the most prevalent inflammatory breast lesion. About two-thirds of malignant cases are non-Arab. Invasive ductal carcinoma with no special type (NST) is the most common malignant subtype.

Prevalence and risk factors of gallbladder polyps in primary health care centers among patients examined by abdominal ultrasonography in Qatar: a case-control study.

BACKGROUND: Gallbladder (GB) polyps are raised lesions from the GB wall and projected into its lumen. The prevalence of GB polyps ranged between 4.3% and 12.3%. The clinical presentation of GB polypoid lesions vary, can be nonspecific and vague, and may be asymptomatic. Identifying malignant and premalignant polyps is important to provide treatment early and prevent cancer spread or development of malignancy. Ultrasonography (US) is the first imaging modality widely used in abdominal imaging. It is a noninvasive, rapid, painless, and safe imaging technique, with no radiation; thus, it is considered the best available examination with good sensitivity and specificity for GB polyps. AIM OF THE WORK: This study aimed to determine the relative frequency of the GB polyps and its risk factors among patients who underwent abdominal US in Primary Health Care Corporation, Qatar. MATERIALS AND METHODS: This was quantitative multicenter observational case-control study nested in a cross-sectional design. For the cross-sectional top-level study, the first step was to assess available abdominal ultrasound studies for the presence of GB polyps and stones. The second step was to perform a case-control study with three groups (a case group and two control groups; first, participants without GB stones and GB polyps; second, patients with GB stones but without GB polyps). RESULTS: The study evaluated the GB images of 7156 individuals. The overall prevalence of GB polyps was 7.4% in the study population. Specifically, the overall prevalence of solitary GB polyp was 4.2% and that of multiple GB polyps was 3.2%. Regarding the size distribution of GB polyps in positive cases, 89.4% were < 6 mm, 9.3% were 69 mm, and 1.3% were ≥ 10 mm. Prevalence rate of selected comorbidities were as follows: liver disease, 1.8%; diabetes mellitus, 25.5%; hypertension, 25.5%; and dyslipidemia, 29.8%. The prevalence in male and female patients was 7.7% and 7%, respectively. The prevalence of GB polyps was higher in south-eastern patients (21.4% of positive cases) and was the highest in the overweight group (8.8%). A higher prevalence was noted in the hypertensive group (hypertensive group, 9.8%; non-hypertensive group, 6.6%) and dyslipidemia group (dyslipidemia group, 7.8%; no dyslipidemia group, 7.2%). Moreover, a higher prevalence was noted in hepatitis B surface (HBS)-positive group (15%) than in the HBS-negative group (8.2%) and slightly higher in Helicobacter pylori antigen positive group than in the negative group. CONCLUSION: Abdominal US is an important and commonly used imaging modality in the detection of GB polyps. In this study, the prevalence of GB polyps was approximately 7.4%, with higher prevalence in participants who were overweight and had diabetes mellitus, hypertension, and dyslipidemia.

The prognostic value of seminal anti-sperm antibodies screening in men prepared for ICSI: a call to change the current antibody-directed viewpoint of sperm autoimmunity testing.

AIMS: We aimed to prospectively evaluate the prognostic value of seminal anti-sperm antibodies (ASA) screening in couples prepared for intracytoplasmic sperm injection (ICSI). METHODS: A prospective comparative study was conducted, including 184 non-azoospermic infertile men scheduled for ICSI. For each patient, detection of ASA in seminal plasma using the ELISA technique was done and its relation to standard semen parameters and ICSI outcomes, including fertilization, embryo development, and pregnancy rates, was analyzed. RESULTS: Sperm count, motility, and morphology were negatively affected by existence of seminal ASA (p = 0.012, 0.006, and 0.011, respectively). However, no statistically significant difference was detected between patients with positive and negative seminal ASA regarding the median values of fertilization (56.3% versus 66.7%, p = 0.091), percentage of couples with grade A embryo development (91.4% versus 89.9%, p = 0.520), and pregnancy rates (31.4% versus 32.2%, p = 0.98) after ICSI. CONCLUSION: ICSI seems able to overcome the problem of ASA in semen. The routine screening of ASA in men prepared for ICSI has no additional prognostic value and cannot be recommended for the time being, until more specific antigen-concerned testing can be developed.

Fluoroscopy-free double-J stent placement through ureteroscope working channel postuncomplicated ureteroscopic laser lithotripsy: A novel technique.

OBJECTIVES: To report a technique for ureteroscopic laser lithotripsy (URSL) and retrograde placement of a double-J (DJ) stenting through the ureteroscope working channel without the use of a fluoroscope compared to the conventional technique. PATIENTS AND METHODS: Between June 2015 and December 2017, 170 patients selected for URSL for treatment of ureteral stones and DJ insertion was evaluated. Patients are divided into two groups according to the use of fluoroscopy. In Group A (100 patients), fluoroscope is used and group B (70 patients) without fluoroscopy guidance. In group B, URSL is performed first and followed by DJ insertion by the semi-rigid ureteroscope 8.5-11 Fr under vision without fluoroscopy. RESULTS: Stone free rate in 96% versus 94.3% for groups A and B respectively. This technique was successful in all the included patients: 166 retrograde DJ stenting post URSL for ureteric calculi and 4 cases for anuria. Group A are exposed to radiation with mean 26.6 seconds in URSL procedure and 4.8 seconds for DJ stenting. Group B was exposed to zero dose. For group A, the stents size was 6 Fr for 70% of patients and 15 % for 4.7 Fr and 15% for 7 Fr stenting. In Group B, stents of 4.7 Fr and length 24-26 cm were used in all patients. Failure of DJ insertion is reported in 9% for group A and 13 (18.5%) patients for group B. CONCLUSIONS: This study report the feasibility and efficacy of the completely fluoroscopy free URSL and DJ stenting to treat ureteric stones.

Ultrasound-guided percutaneous sclerotherapy of simple renal cysts with n-butyl cyanoacrylate and iodized oil mixture as an outpatient procedure.

OBJECTIVE: The aim of this study was to evaluate the efficacy and safety of ultrasound guided percutaneous sclerotherapy of symptomatic simple renal cysts with n-butyl cyanoacrylate (NBCA) and iodized oil mixture as an outpatient single session procedure. MATERIALS AND METHODS: A total of ninety two patients with 100 symptomatic simple renal cysts (larger than 5 cm) were treated by ultrasound (US)-guided percutaneous aspiration and injection of NBCA and iodized oil mixture. The patients (68 men and 24 women, mean age, 42.4 ± 10.5 years) were treated with as out-patients. The volume of the treated cysts was calculated with periodic noncontrast enhanced CT examinations 3, 6 and 9, months after the procedure. The procedure was considered successful at follow-up CT when there was total ablation or greater than 80% reduction of size with resolution of symptoms, respectively. Failure was defined as less than 80% reduction and/or persistent symptoms. RESULTS: The sclerotherapy was technically successful in all patients. The diameter of the cysts ranged between 5.5 and 13.5 cm (mean, 8.8 ± 1.4 cm), and 1.5 and 3.8 cm (mean, 2.1 ± 0.4 cm) before and after sclerotherapy, respectively (P < 0.001). Average diameter reduction was 83.7% during the follow-up period. The mean follow- up lasted 7.1 months (3-11 months). Flank pain resolved in 86 of 92 symptomatic patients (93.48%). In six patients, the symptoms decreased slightly. The procedure was successful in 98 of 100 cysts (98%), demonstrated by follow-up CT. The only two failed cyst was larger than 10 cm in diameter and don't required any further treatment. We did not observe any procedure related complications. CONCLUSION: Ultrasound guided percutaneous sclerotherapy with NBCA and iodized oil mixture for management of symptomatic simple renal cysts was found to be a real time, effective, safe, well tolerated, alternative and simple technique that can be carried out by urologists as an outpatient procedure.

Probing the plasmonic near-field of gold nanocrescent antennas.

We present an investigation of the plasmon-induced electromagnetic near-field around gold nanocrescent (NC) antennas which exhibit localized surface plasmon resonances (LSPRs) in the infrared. To probe the near-field behavior, we monitored the LSPR shift of NCs to adsorption of dielectric layers of varying thickness. The experimental results are analyzed using theoretical simulations, and the EM field decay lengths for the NCs are determined. We discuss how the structural properties of NC antennas influence the near-field properties and compare the results with the near-fields of other metal nanostructures. We show that the near-field distribution around NCs depends strongly on the structural parameters of the NC and that its spatial extent can be tuned to large distances (>700 nm) from the nanostructure surface. In addition, we discuss NC antenna structural changes associated with exposure to ethanol and buffer solutions and the impact on LSPR properties.

Perforated semishells: far-field directional control and optical frequency magnetic response.

Reduced-symmetry plasmonic nanostructures can be designed to support a range of novel optical phenomena, such as nanoscale control of the far-field scattering profile and magnetic resonances at optical frequencies. A family of reduced-symmetry nanostructures--plasmonic semishells with specifically shaped and oriented perforations introduced into the metallic shell layer--can be tailored to control these effects. Unlike core-shell nanoparticles, perforated semishells can be fabricated using a combination of clean-room techniques. For a semishell with a single spherical perforation positioned on its symmetry axis, we examine how the resonant modes of the structure depend on hole size and shape. Placing the perforation off the symmetry axis allows a family of higher-order modes to be excited in the nanostructure, along with complex near-field charge distributions for the various resonant modes. This reduced-symmetry case provides a platform for optical studies, which agree quite well with theoretical analysis. Our study also examines two important variations of this structure: a semishell with multiple perforations in the shell layer, and a semishell with a wedge-like "slice" in the shell layer. A semishell with a wedge-like perforation can be thought of as a three-dimensional analogue of a split-ring resonator (SRR), an important nanoscale component in metamaterial design. Here we show that the dimensions of the wedge-like perforation, which control the effective optical frequency resistance, inductance, and capacitance of this structure, determine the frequency of the magnetic mode.

Magnetic-plasmonic core-shell nanoparticles.

Nanoparticles composed of magnetic cores with continuous Au shell layers simultaneously possess both magnetic and plasmonic properties. Faceted and tetracubic nanocrystals consisting of wustite with magnetite-rich corners and edges retain magnetic properties when coated with a Au shell layer, with the composite nanostructures showing ferrimagnetic behavior. The plasmonic properties are profoundly influenced by the high dielectric constant of the mixed iron oxide nanocrystalline core. A comprehensive theoretical analysis that examines the geometric plasmon tunability over a range of core permittivities enables us to identify the dielectric properties of the mixed oxide magnetic core directly from the plasmonic behavior of the core-shell nanoparticle.

Plasmonic properties of a metallic torus.

Using the plasmon hybridization method, we investigate the optical properties of metallic tori of different shapes and for different polarizations. The plasmon energies are found to be strongly dependent on polarization and on the aspect ratio of the torus, which we define as the ratio of the radii of the two circles that define the structure. For incident light polarized in the plane of the torus, the optical spectrum is characterized by two features, a long wavelength highly tunable dipolar plasmon resonance, and a short wavelength mode corresponding to excitation of several higher order torus modes. For aspect ratios smaller than 0.8, we find that the energy of the tunable dipolar torus mode can be described analytically as an infinite cylinder plasmon of a wavelength equal to the length of the tube. For perpendicular polarization, the spectrum exhibits a single feature made up of several closely spaced higher order torus modes which are only weakly dependent on the aspect ratio. The calculated optical properties are found to be in excellent agreement with results from numerical finite difference time domain calculations and with results from other groups.