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1.
Sci Transl Med ; 16(751): eadi5336, 2024 Jun 12.
Article in English | MEDLINE | ID: mdl-38865484

ABSTRACT

In chronic myeloid leukemia (CML), the persistence of leukemic stem cells (LSCs) after treatment with tyrosine kinase inhibitors (TKIs), such as imatinib, can lead to disease relapse. It is known that therapy-resistant LSCs rely on oxidative phosphorylation (OXPHOS) for their survival and that targeting mitochondrial respiration sensitizes CML LSCs to imatinib treatment. However, current OXPHOS inhibitors have demonstrated limited efficacy or have shown adverse effects in clinical trials, highlighting that identification of clinically safe oxidative pathway inhibitors is warranted. We performed a high-throughput drug repurposing screen designed to identify mitochondrial metabolism inhibitors in myeloid leukemia cells. This identified lomerizine, a US Food and Drug Administration (FDA)-approved voltage-gated Ca2+ channel blocker now used for the treatment of migraines, as one of the top hits. Transcriptome analysis revealed increased expression of voltage-gated CACNA1D and receptor-activated TRPC6 Ca2+ channels in CML LSCs (CD34+CD38-) compared with normal counterparts. This correlated with increased endoplasmic reticulum (ER) mass and increased ER and mitochondrial Ca2+ content in CML stem/progenitor cells. We demonstrate that lomerizine-mediated inhibition of Ca2+ uptake leads to ER and mitochondrial Ca2+ depletion, with similar effects seen after CACNA1D and TRPC6 knockdown. Through stable isotope-assisted metabolomics and functional assays, we observe that lomerizine treatment inhibits mitochondrial isocitrate dehydrogenase activity and mitochondrial oxidative metabolism and selectively sensitizes CML LSCs to imatinib treatment. In addition, combination treatment with imatinib and lomerizine reduced CML tumor burden, targeted CML LSCs, and extended survival in xenotransplantation model of human CML, suggesting this as a potential therapeutic strategy to prevent disease relapse in patients.


Subject(s)
Drug Repositioning , Leukemia, Myelogenous, Chronic, BCR-ABL Positive , Mitochondria , Humans , Mitochondria/metabolism , Mitochondria/drug effects , Leukemia, Myelogenous, Chronic, BCR-ABL Positive/drug therapy , Leukemia, Myelogenous, Chronic, BCR-ABL Positive/pathology , Leukemia, Myelogenous, Chronic, BCR-ABL Positive/metabolism , Animals , Cell Line, Tumor , Endoplasmic Reticulum/metabolism , Endoplasmic Reticulum/drug effects , Piperazines/pharmacology , Piperazines/therapeutic use , Mice , Neoplastic Stem Cells/drug effects , Neoplastic Stem Cells/metabolism , Neoplastic Stem Cells/pathology , Calcium/metabolism , Oxidative Phosphorylation/drug effects , Imatinib Mesylate/pharmacology , Imatinib Mesylate/therapeutic use
2.
Life (Basel) ; 14(5)2024 May 17.
Article in English | MEDLINE | ID: mdl-38792661

ABSTRACT

Nitrogen is an essential element for maize growth, but excessive application can lead to various environmental and ecological issues, including water pollution, air pollution, greenhouse gas emissions, and biodiversity loss. Hence, developing maize hybrids resilient to low-N conditions is vital for sustainable agriculture, particularly in nitrogen-deficient soils. Combining ability and genetic relationships among parental lines is crucial for breeding superior hybrids under diverse nitrogen levels. This study aimed to assess the genetic diversity of maize inbred lines using simple sequence repeat (SSR) markers and evaluate their combining ability to identify superior hybrids under low-N and recommended conditions. Local and exotic inbred lines were genotyped using SSR markers, revealing substantial genetic variation with high gene diversity (He = 0.60), moderate polymorphism information content (PIC = 0.54), and an average of 3.64 alleles per locus. Twenty-one F1 hybrids were generated through a diallel mating design using these diverse lines. These hybrids and a high yielding commercial check (SC-131) were field-tested under low-N and recommended N conditions. Significant variations (p < 0.01) were observed among nitrogen levels, hybrids, and their interaction for all recorded traits. Additive genetic variances predominated over non-additive genetic variances for grain yield and most traits. Inbred IL3 emerged as an effective combiner for developing early maturing genotypes with lower ear placement. Additionally, inbreds IL1, IL2, and IL3 showed promise as superior combiners for enhancing grain yield and related traits under both low-N and recommended conditions. Notably, hybrids IL1×IL4, IL2×IL5, IL2×IL6, and IL5×IL7 exhibited specific combining abilities for increasing grain yield and associated traits under low-N stress conditions. Furthermore, strong positive associations were identified between grain yield and specific traits like plant height, ear length, number of rows per ear, and number of kernels per row. Due to their straightforward measurability, these relationships underscore the potential of using these traits as proxies for indirect selection in early breeding generations, particularly under low-N stress. This research contributes to breeding nitrogen-efficient maize hybrids and advances our understanding of the genetic foundations for tolerance to nitrogen limitations.

3.
Cureus ; 16(3): e55758, 2024 Mar.
Article in English | MEDLINE | ID: mdl-38586735

ABSTRACT

Situs inversus totalis (SIT) is a rare congenital condition where the organs of the thorax and abdomen are arranged in a mirror image reversal of their normal position. Patients with SIT present unique challenges in surgical procedures, particularly in laparoscopic surgeries, due to the need to reverse the operator's perspective, technical difficulty in handling the instruments, anatomical variations, and an increased risk of intraoperative complications. In this case report, we present the first case in the English literature of a 49-year-old Arabic male patient with SIT who underwent a successful right laparoendoscopic single-site surgery donor nephrectomy. We described the surgical technique used and highlighted the key challenges faced and overcome during the procedure.

4.
J Surg Case Rep ; 2023(10): rjad564, 2023 Oct.
Article in English | MEDLINE | ID: mdl-37846424

ABSTRACT

We present a case of congenital of flexor pollicis longus agenesis without thenar hypoplasia in a 12-year-old girl with no history of trauma. Two-staged corrective surgery was planned. In the first stage, the flexor pulley was reconstructed using silicone followed by the second stage 3 months later when flexor pollicis longus reconstruction was performed using tendon transfer of the flexor digitorum superficialis. The patient completed post-operative physiotherapy and the result of the surgical treatment in both functional and cosmetic aspects was, in the authors' opinion, excellent.

5.
J Surg Case Rep ; 2023(9): rjad501, 2023 Sep.
Article in English | MEDLINE | ID: mdl-37701450

ABSTRACT

Congenital hand and forearm anomalies pose a unique challenge in plastic and pediatric surgery. We present a case report of an 8-months-old girl with a congenital left sided hand and forearm anomaly, provisionally diagnosed as atypical left mirror hand anomaly. Classically there is absence of radius and duplication of ulna; however, our case had normal radius and ulna and a hand with seven digits arranged in two groups. We did a surgery which involved a ray amputation of the finger ulnar to the most radial digit, aiming to preserve an adequate first web space to reconstruct the thumb. The result of the surgical treatment in both functional and cosmetic aspects was, in authors' opinion, good.

6.
Cureus ; 15(8): e42990, 2023 Aug.
Article in English | MEDLINE | ID: mdl-37671234

ABSTRACT

Adolescents increasingly find it difficult to picture their lives without social media. Practitioners need to be able to assess risk, and social media may be a new component to consider. Although there is limited empirical evidence to support the claim, the perception of the link between social media and mental health is heavily influenced by teenage and professional perspectives. Privacy concerns, cyberbullying, and bad effects on schooling and mental health are all risks associated with this population's usage of social media. However, ethical social media use can expand opportunities for connection and conversation, as well as boost self-esteem, promote health, and gain access to critical medical information. Despite mounting evidence of social media's negative effects on adolescent mental health, there is still a scarcity of empirical research on how teens comprehend social media, particularly as a body of wisdom, or how they might employ wider modern media discourses to express themselves. Youth use cell phones and other forms of media in large numbers, resulting in chronic sleep loss, which has a negative influence on cognitive ability, school performance, and socio-emotional functioning. According to data from several cross-sectional, longitudinal, and empirical research, smartphone and social media use among teenagers relates to an increase in mental distress, self-harming behaviors, and suicidality. Clinicians can work with young people and their families to reduce the hazards of social media and smartphone usage by using open, nonjudgmental, and developmentally appropriate tactics, including education and practical problem-solving.

7.
Medicina (Kaunas) ; 59(9)2023 Sep 11.
Article in English | MEDLINE | ID: mdl-37763764

ABSTRACT

Immune thrombocytopenia (ITP) is an autoimmune bleeding disorder caused by antigen-specific T cells and antiplatelet autoantibodies that inhibit platelet production in the bone marrow or destroy platelets in the spleen. ITP is a form of autoimmunity and is closely associated with inflammation. Corticosteroids are the first-line therapy for ITP, with a total response rate of 53-80%. However, corticosteroid therapy is associated with significant side effects and is often ineffective in patients with corticosteroid-resistant or -intolerant disease. Eltrombopag has been validated as a second-line option in ITP therapy. Despite several studies demonstrating the efficacy and safety of Eltrombopag in immune thrombocytopenia patients, the prevalence of Eltrombopag-induced acute kidney injury has been observed. This case report describes a patient who experienced acute kidney injury during Eltrombopag therapy. A sudden increase in serum creatinine to 6.7 mg/dL and metabolic acidosis occurred after eight weeks of Eltrombopag. The patient's renal failure had worsened, proteinuria was detected, and emergency hemodialysis was initiated. With vigilant kidney function screening and prompt treatment, the patient's renal function improved remarkably following cessation of Eltrombopag and initiation of hemodialysis. This case highlights the importance of comprehensive medication history-taking and vigilant kidney function screening in patients receiving Eltrombopag.

8.
Pharmaceuticals (Basel) ; 16(9)2023 Aug 29.
Article in English | MEDLINE | ID: mdl-37765023

ABSTRACT

BACKGROUND: Primary immune thrombocytopenia (ITP) is an inflammatory autoimmune disease that can be managed with several treatment options. However, there is a lack of comparative data on the efficacy of these options in different phases of the disease. AIM OF THE STUDY: This study aimed to evaluate the efficacy of high-dose Dexamethasone (HD-DXM), Prednisolone + Azathioprine, Rituximab, Eltrombopag, and Romiplostim schedules in persistent, chronic refractory or relapsed Egyptian ITP patients with a platelet count ≤30 × 109/L. The primary outcome measure was a sustained increase in platelet counts over 50 × 109/L for an additional 12 months without additional ITP regimens. The study also aimed to identify a suitable treatment regimen with a long remission duration for each phase of ITP. RESULTS: Prednisolone + Azathioprine was significantly more effective in achieving an overall response in persistent patients than Romiplostim, high-dose Dexamethasone, and Rituximab. (90.9% vs. 66.6, [Odds ratio, OR: 5; confidence interval, CI 95% (0.866-28.86)], 45%, [OR: 0.082, CI 95% (0.015-0.448)] and, 25%, [OR: 30, CI 95% (4.24-211.8)], respectively, p-value < 0.01). Eltrombopag was significantly more effective in achieving a durable response in refractory ITP than HD-DXM, Rituximab, and Prednisolone; (80% compared to 32.2% [OR: 0.119, CI 95% (0.035-0.410)], 22.2% [OR:0.071, CI 95% (0.011-0.455)], and 18.1% [OR: 0.056, CI 95% (0.009-0.342)], respectively, p-value < 0.01). CONCLUSIONS: Finally, Eltrombopag following HD-DXM showed the highest percentage of patients with complete treatment-free survival times of at least 330 days. These findings could help clinicians choose the most appropriate treatment for their patients with ITP based on the phase of the disease. This trial is registered in clinicaltrials.gov with registration number NCT05861297.

9.
Nat Commun ; 14(1): 4634, 2023 08 17.
Article in English | MEDLINE | ID: mdl-37591854

ABSTRACT

Deregulated oxidative metabolism is a hallmark of leukaemia. While tyrosine kinase inhibitors (TKIs) such as imatinib have increased survival of chronic myeloid leukaemia (CML) patients, they fail to eradicate disease-initiating leukemic stem cells (LSCs). Whether TKI-treated CML LSCs remain metabolically deregulated is unknown. Using clinically and physiologically relevant assays, we generate multi-omics datasets that offer unique insight into metabolic adaptation and nutrient fate in patient-derived CML LSCs. We demonstrate that LSCs have increased pyruvate anaplerosis, mediated by increased mitochondrial pyruvate carrier 1/2 (MPC1/2) levels and pyruvate carboxylase (PC) activity, in comparison to normal counterparts. While imatinib reverses BCR::ABL1-mediated LSC metabolic reprogramming, stable isotope-assisted metabolomics reveals that deregulated pyruvate anaplerosis is not affected by imatinib. Encouragingly, genetic ablation of pyruvate anaplerosis sensitises CML cells to imatinib. Finally, we demonstrate that MSDC-0160, a clinical orally-available MPC1/2 inhibitor, inhibits pyruvate anaplerosis and targets imatinib-resistant CML LSCs in robust pre-clinical CML models. Collectively these results highlight pyruvate anaplerosis as a persistent and therapeutically targetable vulnerability in imatinib-treated CML patient-derived samples.


Subject(s)
Leukemia, Myelogenous, Chronic, BCR-ABL Positive , Pyruvic Acid , Humans , Imatinib Mesylate/pharmacology , Imatinib Mesylate/therapeutic use , Leukemia, Myelogenous, Chronic, BCR-ABL Positive/drug therapy , Leukemia, Myelogenous, Chronic, BCR-ABL Positive/genetics , Acclimatization , Biological Assay
10.
Pharmaceuticals (Basel) ; 16(6)2023 Jun 12.
Article in English | MEDLINE | ID: mdl-37375815

ABSTRACT

Immune thrombocytopenia (ITP) treatment has evolved recently. However, none of the treatments have only benefits without drawbacks. This study aimed to compare the clinical outcomes and adverse drug patterns of Eltrombopag, Romiplostim, Prednisolone + Azathioprine, High Dose-dexamethasone (HD-DXM) (control group), and Rituximab in primary ITP Egyptian patients. All patients were initiated with corticosteroids, HD-DXM, as a first-line treatment for the first month immediately following diagnosis. Four hundred sixty-seven ITP patients were randomly assigned to five groups. The outcome measures were judged at baseline, at the end of treatment (6 months), and after an additional 6-month free treatment period. The follow-up period for which relapse is noted was 6 months after the end of treatment. Eltrombopag and Romiplostim resulted in a significantly higher incidence of sustained response than Rituximab, HD-DXM, and Prednisolone + Azathioprine (55.2% and 50.6% vs. 29.2%, 29.1%, and 18%, respectively; p-value < 0.001). More patients on immunomodulators (Prednisolone+ Azathioprine, HD-DXM, and Rituximab) relapsed than those on Romiplostim and Eltrombopag (81.9%, 70.8%, and 70.7% vs. 49.3%, and 44.7%, respectively; p-value < 0.01). We also describe 23 reports of pulmonary hypertension with Prednisolone+ Azathioprine and 13 reports with HD-DXM. The thrombotic events occurred in 16.6% and 13% of patients who received Eltrombopag and Romiplostim treatment, respectively. Most patients had at least one or two risk factors (92.8% of cases). Corticosteroids are effective first-line therapy in primary ITP patients. However, relapse is frequent. Eltrombopag and Romiplostim are safer and more effective than Prednisolone, HD-DXM, and Rituximab. They might be reasonable beneficial options after a one-month HD-DXM regimen.

11.
Vasc Health Risk Manag ; 19: 201-210, 2023.
Article in English | MEDLINE | ID: mdl-37050930

ABSTRACT

Background: A little is known about the risk factors and predictors of pulmonary embolism (PE) in Coronavirus disease 2019 (Covid-19) infected patients. Therefore, we directed this study to investigate the predictors of PE in patients infected with Covid - 19 in Upper Egypt. Methods: We conducted a retrospective cohort study on 297 patients infected with COVID-19, aged ≥ 18 years old. Suspicion of COVID-19 infection was based on the World Health Organization (WHO) criteria and confirmed by nasal and pharyngeal swab for real-time reverse transcriptase-polymerase chain reaction (RT-PCR) analysis. The patient was also determined to have COVID-19 when CT results that were thought to be typical for COVID-19 and clinical data that were compatible were present. Results: PE was diagnosed in 18.2% of patients. We found that the incidence of PE was significantly higher in older patients, females, those with higher BMI, hypertensive patients, diabetics, and patients with co-morbidities. Also, PE was significantly higher in patients presented with dyspnea, chest pain, longer duration of symptoms at hospital admission, and lower oxygen concentration. The mean serum Hb level, platelet count, TLC and absolute lymphocytic count were markedly reduced in those who had PE. All the patients who developed PE had a CO-RADS scale five on their CT chest scan. Age > 65, BMI > 25, DM, and associated co-morbidities were the independent patients' characteristics associated with the development of PE after the multivariate regression analysis. Conclusion: PE is a common complication of Covid 19 infection. PE is associated with a variety of clinical and laboratory parameters in univariate analysis, but age > 65, BMI > 25, DM, and associated co-morbidities were the independent patients' characteristics associated with the development of PE in those infected with Covid-19.


Subject(s)
COVID-19 , Pulmonary Embolism , Female , Humans , Aged , Adolescent , COVID-19/complications , COVID-19/diagnosis , COVID-19/epidemiology , SARS-CoV-2 , Retrospective Studies , Egypt/epidemiology , Pulmonary Embolism/diagnostic imaging , Pulmonary Embolism/epidemiology
12.
Cureus ; 15(1): e33257, 2023 Jan.
Article in English | MEDLINE | ID: mdl-36741652

ABSTRACT

Introduction Hypertension (HTN) is one of the most important cardiovascular risk factors. It is associated with significant complications, such as coronary artery disease, stroke, and chronic kidney disease. Awareness among hypertensive patients regarding their blood pressure (BP) is low in the Kingdom of Saudi Arabia. Aim This study aimed to evaluate the awareness of patients regarding their BP readings and to identify which aspects of HTN they needed to be informed about. Patients and methods A descriptive cross-sectional study was conducted among hypertensive patients attending outpatient clinics at King Fahad Medical City, Riyadh, Saudi Arabia. An electronic questionnaire was used by a trained physician to collect data from patients during telephone interviews. The information included socio-demographic data (i.e., age, gender, and education), family history, compliance with medications, and BP measurements. Patients were asked to answer questions to assess their awareness of their BP readings. Results Of the 475 hypertensive patients included in this study, 32.7% were aged between 56 and 65 years and 60.4% were female. The proportion of patients who had knowledge of their target BP (systolic: 120-129 mmHg; diastolic: 80-84 mmHg) was 74.4%. The significant independent predictors of increased knowledge about BP were a high level of education, regular measurement of BP, and having received education about a healthy lifestyle. The significant independent predictor of decreased knowledge about BP was having an acceptable or poor understanding of chronic BP. Conclusion Hypertensive patients visiting the outpatient clinic at King Fahad Hospital had a good understanding of their target BP readings. Educated patients who regularly measured their BP and who received education about a healthy lifestyle tended to exhibit a higher motivation to achieve their BP targets. More research is needed to gain more insights into the knowledge of hypertensive patients and into how they manage their BP to determine the factors that influence their knowledge.

13.
Sci Data ; 10(1): 33, 2023 01 18.
Article in English | MEDLINE | ID: mdl-36653372

ABSTRACT

Hepatocellular carcinoma (HCC) is the most common primary liver neoplasm, and its incidence has doubled over the past two decades owing to increasing risk factors. Despite surveillance, most HCC cases are diagnosed at advanced stages and can only be treated using transarterial chemo-embolization (TACE) or systemic therapy. TACE failure may occur with incidence reaching up to 60% of cases, leaving patients with a financial and emotional burden. Radiomics has emerged as a new tool capable of predicting tumor response to TACE from pre-procedural computed tomography (CT) studies. This data report defines the HCC-TACE data collection of confirmed HCC patients who underwent TACE and have pre- and post-procedure CT imaging studies and available treatment outcomes (time-to-progression and overall survival). Clinically curated segmentation of pre-procedural CT studies was done for the purpose of algorithm training for prediction and automatic liver tumor segmentation.


Subject(s)
Carcinoma, Hepatocellular , Liver Neoplasms , Humans , Carcinoma, Hepatocellular/diagnostic imaging , Carcinoma, Hepatocellular/therapy , Chemoembolization, Therapeutic/adverse effects , Chemoembolization, Therapeutic/methods , Liver Neoplasms/diagnostic imaging , Liver Neoplasms/therapy , Treatment Outcome
14.
J Environ Public Health ; 2022: 8425798, 2022.
Article in English | MEDLINE | ID: mdl-36060879

ABSTRACT

Humans and all other living things depend on having access to clean water, as it is an indispensable essential resource. Therefore, the development of a model that can predict water quality conditions in the future will have substantial societal and economic value. This can be accomplished by using a model that can predict future water quality circumstances. In this study, we employed a sophisticated artificial neural network (ANN) model. This study intends to develop a hybrid model of single exponential smoothing (SES) with bidirectional long short-term memory (BiLSTM) and an adaptive neurofuzzy inference system (ANFIS) to predict water quality (WQ) in different groundwater in the Al-Baha region of Saudi Arabia. Single exponential smoothing (SES) was employed as a preprocessing method to adjust the weight of the dataset, and the output from SES was processed using the BiLSTM and ANFIS models for predicting water quality. The data were randomly divided into two phases, training (70%) and testing (30%). Efficiency statistics were used to evaluate the SES-BiLSTM and SES-ANFIS models' prediction abilities. The results showed that while both the SES-BiLSTM and SES-ANFIS models performed well in predicting the water quality index (WQI), the SES-BiLSTM model performed best with accuracy (R = 99.95% and RMSE = 0.00910) at the testing phase, where the performance of the SES-ANFIS model was R = 99.95% and RMSE = 2.2941 × 100-07. The findings support the idea that the SES-BilSTM and SES-ANFIS models can be used to predict the WQI with high accuracy, which will help to enhance WQ. The results demonstrated that the SES-BiLSTM and SES-ANFIS models' forecasts are accurate and that both seasons' performances are consistent. Similar investigations of groundwater quality prediction for drinking purposes should benefit from the proposed SES-BiLSTM and SES-ANFIS models. Consequently, the results demonstrate that the proposed SES-BiLSTM and SES-ANFIS models are useful tools for predicting whether the groundwater in Al-Baha city is suitable for drinking and irrigation purposes.


Subject(s)
Artificial Intelligence , Groundwater , Fuzzy Logic , Humans , Neural Networks, Computer , Water Quality
15.
J Comput Assist Tomogr ; 46(3): 333-343, 2022.
Article in English | MEDLINE | ID: mdl-35575649

ABSTRACT

BACKGROUND: Routine computed tomography (CT) scans are thought to have poor performance for detection of gastrointestinal (GI) neuroendocrine neoplasms (NENs), which leads to delayed workup. Detection of even 1 bowel tumor can guide diagnostic workup and management. The purposes of this study were to assess the accuracy of multidetector computed tomography (MDCT) and to compare negative versus positive enteric contrast in detecting at least 1 GI tumor per patient with suspected or confirmed diagnosis of a NEN. METHODS: This retrospective study included 107 patients with intravenous and oral contrast (65 positive, 40 negative, and 2 no oral contrast) abdominopelvic MDCT. Two abdominal radiologists independently analyzed the CTs for detection and localization of bowel NENs. Surgical pathology was considered the reference standard. Analyses included κ and summary statistics, McNemar test, Pearson χ2 test, and Fisher exact test. RESULTS: Among the 107 CT scans, there were 30 pathology negative studies and 77 studies with positive pathology for GI NEN. Interreader agreement for CT evaluation was substantial (κ = 0.61). At least 1 GI NEN per patient was detected with 51% to 53% sensitivity, 87% to 93% specificity, 91% to 95% positive predictive value (PPV), 42% negative predictive value, and 63% accuracy for each reader, and 57% accuracy when only the concordant (ie, matching) results of the 2 readers were considered. Computed tomography scans with negative enteric contrast had significantly higher sensitivity for concordant results than CTs with positive enteric contrast (58% vs 30%, P = 0.01). Specificity (100% vs 95%, P = 0.5), PPV (100% vs 93%, P = 0.49), negative predictive value (39% vs 39%, P = 0.99), and accuracy (67% vs 51%, P = 0.10) were not significantly different for negative versus positive enteric contrast for the concordant results. There was no significant difference in GI NEN localization between the readers. CONCLUSIONS: Routine MDCT with either positive or negative enteric contrast can detect at least 1 GI tumor per patient with more than 90% PPV and more than 50% accuracy in patients suspected of GI NEN. Using negative enteric contrast improves sensitivity for GI NEN versus positive enteric contrast. In addition, there is high accuracy in localizing the bowel tumor with positive or negative enteric contrast, which may guide surgery. Radiologists should have heightened awareness that evaluating such scans closely may lead to detection of primary bowel NENs at a higher rate than previously reported.


Subject(s)
Multidetector Computed Tomography , Neuroendocrine Tumors , Contrast Media , Humans , Intestine, Small/pathology , Multidetector Computed Tomography/methods , Neuroendocrine Tumors/diagnostic imaging , Neuroendocrine Tumors/pathology , Retrospective Studies , Sensitivity and Specificity
16.
Dysphagia ; 37(5): 1266-1270, 2022 10.
Article in English | MEDLINE | ID: mdl-34802084

ABSTRACT

Fluoroscopic barium swallow examinations are a commonly performed radiologic study in the evaluation of dysphagia. These studies remain essential in the diagnostic work-up despite the increasing utilization of endoscopy, but current residents are often less experienced with fluoroscopy. Structured reporting has been demonstrated to improve comprehensiveness of reports in multiple settings, but has not been evaluated for barium swallow examinations. A retrospective review identified patients who underwent barium swallow examinations pre-structured reporting in 2017 and followed a multidisciplinary proposal for and adoption of an optional structured report in 2020. Reports were assessed for comprehensiveness by evaluating presence/absence each element (total of 10 elements). Differences in report elements between groups and multiple subgroups was performed utilizing a Mann-Whitney U test. χ2 tests were also utilized to evaluate inclusion of each individual element of the report. A total of 487 reports from 2020 and 757 reports from 2017 were analyzed. Certain elements showed substantial differences in reporting, with greater than 90% of structured reports including them, but much lower numbers including them in non-structured reports from 2017 and 2020. Reports generated in 2020 had a statistically significant increase in report elements included when compared to 2017 (p < 0.01). This statistically significant increase was also observed in comparison of structured reports and non-structured reports from either period (p < 0.01). Adoption of structured reporting for fluoroscopic barium swallow examinations led to significant increase in report comprehensiveness and should be considered after a multidisciplinary approach to development.


Subject(s)
Barium Sulfate , Deglutition Disorders , Barium , Contrast Media , Deglutition , Deglutition Disorders/diagnostic imaging , Fluoroscopy , Humans
17.
J Cardiovasc Med (Hagerstown) ; 23(4): 264-271, 2022 04 01.
Article in English | MEDLINE | ID: mdl-34878430

ABSTRACT

AIMS: To estimate if chronic anticoagulant (CAC) treatment is associated with morbidity and mortality outcomes of patients hospitalized for SARS-CoV-2 infection. METHODS: In this European multicentric cohort study, we included 1186 patients of whom 144 were on CAC (12.1%) with positive coronavirus disease 2019 testing between 1 February and 30 July 2020. The average treatment effect (ATE) analysis with a propensity score-matching (PSM) algorithm was used to estimate the impact of CAC on the primary outcomes defined as in-hospital death, major and minor bleeding events, cardiovascular complications (CCI), and acute kidney injury (AKI). We also investigated if different dosages of in-hospital heparin were associated with in-hospital survival. RESULTS: In unadjusted populations, primary outcomes were significantly higher among CAC patients compared with non-CAC patients: all-cause death (35% vs. 18% P < 0.001), major and minor bleeding (14% vs. 8% P = 0.026; 25% vs. 17% P = 0.014), CCI (27% vs. 14% P < 0.001), and AKI (42% vs. 19% P < 0.001). In ATE analysis with PSM, there was no significant association between CAC and primary outcomes except for an increased incidence of AKI (ATE +10.2%, 95% confidence interval 0.3-20.1%, P = 0.044). Conversely, in-hospital heparin, regardless of dose, was associated with a significantly higher survival compared with no anticoagulation. CONCLUSIONS: The use of CAC was not associated with the primary outcomes except for the increase in AKI. However, in the adjusted survival analysis, any dose of in-hospital anticoagulation was associated with significantly higher survival compared with no anticoagulation.


Subject(s)
Acute Kidney Injury , COVID-19 , Acute Kidney Injury/chemically induced , Acute Kidney Injury/epidemiology , Anticoagulants/adverse effects , COVID-19/complications , COVID-19 Testing , Cohort Studies , Hospital Mortality , Hospitals , Humans , Retrospective Studies , Risk Factors , SARS-CoV-2
18.
Ital J Food Saf ; 11(4): 10370, 2022 Dec 05.
Article in English | MEDLINE | ID: mdl-36590019

ABSTRACT

Brucella infection in animals is considered a great problem in most countries of the world. Our study designed to determine the prevalence of brucella in field animal's milk in Dhamar governorate, Yemen. Total of 808 raw milk samples from non-aborted field animals, 120 milk samples from aborted animals, and 30 pasteurized milk samples were teste by Milk-Ring Test (MRT), milk-ELISA test, isolation and identification of brucella species, and antibiotic susceptibility. The prevalence of brucella in milk samples from field animals was 0.8%, 2.6%, and 2% in cows, sheep, and goat milk samples respectively with MRT, and 0.8%, 1.3% and 1.6% in cows, sheep and goat milk samples respectively with the milk- ELISA test. The prevalence rate in milk samples from aborted animals was 33%, 64% and 41.2% with the MRT and 39%, 49%, and 41.2% in cows, sheep and goats respectively with the milk-ELISA test. All pasteurized milk samples were negative for the milk-ELISA test. The result of isolation showed 0.1% of Brucella in milk samples from field animals while 9.2% from aborted animals. All isolates of Brucella species were sensitivities to rifampicin, doxycycline, kanamycin, gentamicin, streptomycin, tetracycline, and ciprofloxacin, while resistant to ampicillin, erythromycin, and novobiocin. In conclusion, the high prevalence of milk brucella especially in aborted animals needs focusing and build controlling strategies plans to decrease the losses to the economy and avoid transferred to humans with unpasteurized milk consumption.

19.
Saudi J Biol Sci ; 28(8): 4605-4612, 2021 Aug.
Article in English | MEDLINE | ID: mdl-34354446

ABSTRACT

This study was conducted to evaluate the quality of water in selected dams in Albaha region, Kingdom of Saudi Arabia. Water samples from eight dams were subjected to physical, chemical, and bacteriological assessment using standardized procedures of conductivity, total dissolved solids, ions, acidity & alkalinity, and EC blue 100® coliform detection. About three fourth (75%) of dams' water samples exceeded the permissible levels of pH, total dissolved solids, turbidity, Mn and NO3 set by Saudi standards. Average levels of total dissolved solids, Fe, Mn, SO4, NO3, and NO2 were 3065.00, 0.10, 0.89, 68.25, 17.91 and 0.016 mg/L, respectively. However, the average pH of water samples was 7.95 ±â€¯0.66 which still within the accepted range set by national and global standards. Moreover, total dissolved solids also exceeded regular standards of Food and Agriculture Organization for irrigation water quality. Coliform bacteria were detected in 37.5% of dams without any significant spatial differences between dams and sites as groups. Correlations were found between pH & NO3, SO4 & NO3, coliform bacteria & turbidity, coliform bacteria & NO2 levels. Increased concentrations of assessed parameters in dams may be attributed to agricultural activities as well as animal and human wastes deposited into dams via rainfalls and flash floods. Proper treatment of dams needs to be taken into account before consumption and irrigation.

20.
Plants (Basel) ; 10(7)2021 Jul 13.
Article in English | MEDLINE | ID: mdl-34371634

ABSTRACT

There has been an increased interest in oilseed crops for agro-industry research and development breeding programs to secure sustainable food and agriculture. The introgression of exotic genotypes of oilseed Brassica into cultivated relatives is inevitable in the genetic improvement of oilseed crops. This experimental attempt aimed to characterize the morphological and molecular basis for the identification and characterization of some Brassica genotypes. Fatty acid profile, yield, and morphology are under genetic control and can be used to identify genotypes. Characterization and identification were fulfilled for five accessions from Brassica spp. Plant height, height of first branch, number of branches and pods per plant, seed yield per plant, average pod length, number of seeds per pod, protein and oil contents (%), and fatty acid profile were examined. Besides, the relationship between seed yield and seed yield-contributing characteristics was estimated, as well as the phylogenetic relationship of the internal transcribed spacer (ITS). The genotypes varied significantly for all examined traits, taking into account the most important traits: seed yield per plant and oil content. For example, oil content in the samples ranged between 41.1 and 49.3%. Path analysis results showed a high and positive direct effect between each number of primary branches and the number of pods per plant with seed yield per plant (0.48). The morphological and molecular observations suggest that the Fay1, Fay3, Fay4, and Fay6 accessions belong to Brassica rapa, while Fay2 belongs to Brassica carinata. It can be concluded based on the present findings that the Fay3 genotype with the highest oil content and the lowest erucic acid content compared to the other genotypes can be proposed as a potential donor for future breeding programs for oil production and quality, while Fay1 can be utilized as donor to increase the seed yield per plant.

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