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1.
J Obstet Gynaecol ; : 1-3, 2021 Oct 25.
Artigo em Inglês | MEDLINE | ID: mdl-34693861

RESUMO

As coronavirus disease 2019 (COVID-19) sweeps all over the world, Information about COVID-19 is evolving rapidly and interim guidance by multiple organisations is constantly being updated and expanded. Early with discovery of COVID 19, it was reported that pregnancy did affect the progress of the disease severity. Recently, Centres for Disease Control and Prevention (CDC) reported that pregnancy is a risk factors for COVID-19 severity. The current case report is presenting a peripartum COVID-19 positive mortality case.

2.
Environ Sci Pollut Res Int ; 28(47): 66941-66956, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-34244933

RESUMO

A study is presented on the enhancement of solar still (SS) performance by using chimney exhaust gases (EGs) passing through chimney channels under the still basin. The impact of the exhaust gas temperature on the SS temperature, productivity, efficiency, and freshwater yield cost is considered. The SS performance with the chimney is compared with that of conventional solar still. The study is performed under the hot and cold climate conditions of Upper Egypt. A complete transient mathematical model of the physical model including the solar still regions temperatures, yield, and heat transfer between the SS and the EGs is constructed. This model is solved by using Runge-Kutta method of fourth-order and programmed inside MATLAB software and validated using an experimental setup. The results show that the SS saline water temperature and freshwater yield rise with rising EGs temperatures. Furthermore, the impact of using EGs on the SS performance in winter is superior to that in summer, and also during the daytime is higher than that of night. Using chimney EGs at 75 °C and 125 °C enhances the daily freshwater yield of the SS by more than three times and about six times in winter, respectively, and about two and half times and more than three times in summer, respectively. Using EGs at 125 °C achieves a maximum solar still efficiency of 29.5% in winter and 49.5% in summer with an increase of 41% and 55.7%, respectively, and reduces its yield cost by 63.6% compared to conventional SS.

3.
Multidiscip Respir Med ; 16(1): 742, 2021 Jan 15.
Artigo em Inglês | MEDLINE | ID: mdl-34316367

RESUMO

Background: Despite its wide use in clinical practice, few studies have assessed the role of pulse oximetry in patients with heart failure. We aimed to evaluate the accuracy and precision of the pulse oximeter in patients with heart failure and to determine this accuracy at three different sensor locations. Methods: Comparison of pulse oximetry reading (SpO2) with arterial oxygen saturation (SaO2) was reported in 3 groups of patients with heart failure (HF); those with ejection fraction (EF) >40%, those with EF <40%, and those with acute HF (AHF) with ST and non-ST segment elevation acute myocardial infarction (STEMI and non-STEMI). Results: A total of 235 patients and 90 control subjects were enrolled. There were significant differences in O2 saturation between control and patients' groups when O2 saturation is measured at the finger and toe, but not the ear probes; p=0.029, p=0.049, and 0.051, respectively. In HF with EF>40% and AHF with O2 saturations >90%, finger oximetry is the most accurate and reliable, while in HF with EF<40% and in patients with AHF with O2 saturations <90%, ear oximetry is the most accurate. Conclusion: Pulse oximetry is a reliable tool in assessing oxygen saturation in patients with heart failure of different severity. In HF with EF>40% and in AHF with O2 saturations >90%, finger oximetry is the most accurate and reliable, while in HF with EF<40% and in patients with AHF with O2 saturations <90%, ear oximetry is the most accurate. Further studies are warranted.

4.
Multidiscip Respir Med ; 16(1): 745, 2021 Jan 15.
Artigo em Inglês | MEDLINE | ID: mdl-33936592

RESUMO

Background: Central obesity is a chronic condition that can contribute to impairments in lung functions. Body position is an important technique that effectively restores and increases lung functions. We aimed to address the possible changes in spirometric parameters in asymptomatic overweight individuals with central obesity with a change in posture from sitting to supine in comparison to normal weight non-obese ones. Methods: Enrolled subjects were healthy Egyptian males, aged between 20-45 years old, asymptomatic and nonsmokers. They underwent spirometry. The following parameters were measured; forced expiratory volume in one second (FEV1), forced vital capacity (FVC), FEV1/FVC ratio, and forced expiratory flow (FEF)25-75%. They were classified into overweight with central obesity (n=40) and healthy control (n=40) groups based on their body mass index (BMI), weight-hip ratio (WHR), and waist circumference (WC). Spirometric parameters were compared between the 2 groups and in both setting and supine positions. Results: The central obesity group showed significantly lower all spirometric parameters in comparison to the control one. All measured spirometric parameters had a significant reduction with supine position. There were negative correlations between both the WC and WHR and spirometric parameters. Conclusion: In this study of young Egyptian males, individuals with central obesity had reduced spirometric parameters in comparison to healthy ones. Change in position from sitting to supine has significant effects on spirometric parameters in both healthy middle age males with normal weight and those with overweight and central obesity. These results could have important clinical implications.

5.
Multidiscip Respir Med ; 16(1): 750, 2021 Jan 15.
Artigo em Inglês | MEDLINE | ID: mdl-33936593

RESUMO

Background: The National Comprehensive Cancer Network (NCCN) has adopted the distress thermometer (DT) as one of the best-known distress-screening instruments. We have adopted a modified version of the NCCN distress thermometer. We questioned if this modified DT (m-DT) could be utilized for measuring the prevalence of psychological distress among COVID-19 patients. Methods: The prospective study included 2 phases; modification of the original DT and its associated problem list (PL), and evaluation of this m-DT in measuring the prevalence of psychological distress among COVID-19 patients. Egyptian adult subjects with suspected or confirmed cases of COVID-19 at 2 University Hospitals were enrolled. Binary logistic regression tests were carried out to explore the association between the m-DT cut-off scores of 4 and the clinical variables. Results: One hundred sixty-nine (60.4%) patients experienced significant distress (m-DT cut off score ≥4). Logistic regression showed that occupation, presence of special habits, length of quarantine time, worry, cough, shortness of breath, and fever, were independent factors associated with significant distress in COVID-19 patients. Conclusion: With the modified distress thermometer (m-DT), 60% of Egyptian COVID-19 patients experienced significant distress. This distress was significantly related to age, marital status, occupation, presence or absence of special habits, and length of the quarantine time. With m-DT, the current study had identified worry, being a health-care worker, shortness of breath, fever, length of quarantine time, presence of special habits, and cough as independent factors associated with significant distress in COVID-19 patients. Further studies are warranted.

6.
NMR Biomed ; 34(4): e4474, 2021 04.
Artigo em Inglês | MEDLINE | ID: mdl-33480128

RESUMO

Quantitative 23 Na magnetic resonance imaging (MRI) provides tissue sodium concentration (TSC), which is connected to cell viability and vitality. Long acquisition times are one of the most challenging aspects for its clinical establishment. K-space undersampling is an approach for acquisition time reduction, but generates noise and artifacts. The use of convolutional neural networks (CNNs) is increasing in medical imaging and they are a useful tool for MRI postprocessing. The aim of this study is 23 Na MRI acquisition time reduction by k-space undersampling. CNNs were applied to reduce the resulting noise and artifacts. A retrospective analysis from a prospective study was conducted including image datasets from 46 patients (aged 72 ± 13 years; 25 women, 21 men) with ischemic stroke; the 23 Na MRI acquisition time was 10 min. The reconstructions were performed with full dataset (FI) and with a simulated dataset an image that was acquired in 2.5 min (RI). Eight different CNNs with either U-Net-based or ResNet-based architectures were implemented with RI as input and FI as label, using batch normalization and the number of filters as varying parameters. Training was performed with 9500 samples and testing included 400 samples. CNN outputs were evaluated based on signal-to-noise ratio (SNR) and structural similarity (SSIM). After quantification, TSC error was calculated. The image quality was subjectively rated by three neuroradiologists. Statistical significance was evaluated by Student's t-test. The average SNR was 21.72 ± 2.75 (FI) and 10.16 ± 0.96 (RI). U-Nets increased the SNR of RI to 43.99 and therefore performed better than ResNet. SSIM of RI to FI was improved by three CNNs to 0.91 ± 0.03. CNNs reduced TSC error by up to 15%. The subjective rating of CNN-generated images showed significantly better results than the subjective image rating of RI. The acquisition time of 23 Na MRI can be reduced by 75% due to postprocessing with a CNN on highly undersampled data.

7.
In Vivo ; 35(1): 429-435, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33402493

RESUMO

BACKGROUND/AIM: Sodium (23Na) MR imaging is a noninvasive MRI technique that has been shown to be sensitive to visualize biochemical information about tissue viability, their cell integrity, and cell function in various studies. The aim of this study was to evaluate differences in regional brain 23Na signal intensity between Alzheimer's disease (AD) and healthy controls to preliminarily evaluate the capability of 23Na imaging as a biomarker for AD. PATIENTS AND METHODS: A total of 14 patients diagnosed with AD were included: 12 in the state of dementia and 2 with mild cognitive impairment (MCI), and 12 healthy controls (HC); they were all scanned on a 3T clinical scanner with a double tuned 1H/23Na birdcage head coil. After normalizing the signal intensity with that of the vitreous humor, relative tissue sodium concentration (rTSC) was measured after automated segmentation in the hippocampus, amygdala, basal ganglia, white matter (WM) and grey matter (GM) in both cerebral hemispheres. RESULTS: Patients with AD showed a significant increase in rTSC in comparison to healthy controls in the following brain regions: WM 13.6%; p=0.007, hippocampus 12.9%; p=0.003, amygdala 18.9%; p=0.0007. CONCLUSION: 23Na-MRI has the potential to be developed as a useful biomarker for the diagnosis of AD.


Assuntos
Doença de Alzheimer , Disfunção Cognitiva , Doença de Alzheimer/diagnóstico por imagem , Biomarcadores , Encéfalo/diagnóstico por imagem , Disfunção Cognitiva/diagnóstico por imagem , Humanos , Imageamento por Ressonância Magnética , Sódio
8.
Multidiscip Respir Med ; 15(1): 691, 2020 Jan 28.
Artigo em Inglês | MEDLINE | ID: mdl-32983455

RESUMO

Background: There is no consensus on the most useful predictive indicator for weaning patients from mechanical ventilation (MV). We aimed to evaluate the utility of the modified Burns Wean Assessment Program (m-BWAP) in predicting the weaning success in patients with respiratory disorders admitted to the respiratory intensive care unit (RICU). Methods: Patients with respiratory failure requiring MV for longer than 48 hours were included. They were weaned by pressure support ventilation and spontaneous breathing trails. Patients were divided into successful and unsuccessful weaning groups according to their outcomes. Results: A total of 91 patients were enrolled. The majority had chronic obstructive pulmonary diseases (COPD): 40%, overlap syndrome (24%), and obesity hypoventilation syndrome (OHS): 15%. The successful group had significantly higher m-BWAP scores than that in the unsuccessful group (median 65; range 35 to 80 vs. median 45; range 30 to 65; p=0.000), with area under the curve (AUC) of 0.854; 95% CI 0.766 to 0.919), p<0.001. At cut-off value of ≥55, the sensitivity and specificity of m-BWAP to predict successful weaning were 73.77% and 84.85%, respectively. The AUC for m-BWAP was significantly higher than that for rapid shallow breathing index (RSBI). Conclusion: We conclude that m-BWAP scores represent a good predictor of weaning success among patients with chronic respiratory disorders in the RICU. The m-BWAP checklist has many factors that are closely related to the weaning outcomes of patients with chronic respiratory disorders. Further, large-scale, multicenter studies are warranted.

9.
Multidiscip Respir Med ; 15(1): 465, 2020 Jan 28.
Artigo em Inglês | MEDLINE | ID: mdl-32607231

RESUMO

Background: Few data exist about respiratory viral infections in Egyptian patients. Hereby we describe the outcomes of hospitalized Egyptian patients with severe acute respiratory infections (SARI) admitted to the ICU. Methods: A prospective study in which all hospitalized patients meeting the WHO case definition for SARI and admitted to the ICU, during the period 2010-2014, were enrolled. Samples were tested using RT-PCR for influenza A, B, respiratory syncytial virus (RSV), human metapneumovirus (hMPV), parainfluenza virus, adenovirus, bocavirus, enterovirus, and rhinovirus. Data were analyzed to study the clinical features of SARI-ICU patients and which pathogens are related to severe outcomes. Associated comorbidities were evaluated using Charlson Age-Comorbidity Index (CACI). Results: Out of 1,075 patients with SARI, 219 (20.3%) were admitted to the ICU. The highest rates were reported for RSV (37%). SARI-ICU patients had higher rates of hospital stay, pneumonia, respiratory failure, ARDS, and mortality. Multivariate logistic regression analysis identified associated respiratory disorders (p=0.001), radiological abnormalities (p=0.023), and longer hospital stay (p=0.005) as risk factors for severe outcomes. Conclusions: This surveillance study showed that 20% of hospitalized Egyptian patients with viral SARI needed ICU admission. SARI-ICU patients had higher rates of hospital stay, pneumonia, respiratory failure, ARDS, and mortality. Higher comorbidity index scores, radiological abnormalities, and longer hospital stay are risk factors for severe outcomes in SARI-ICU patients in our locality.

10.
Steroids ; 154: 108527, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-31676306

RESUMO

Hetero-steroids, hybrid anticancer agents, have received much interest in view of their numerous and promising biological activities. In this study, a novel class of hetero-steroids were synthesized, analytical and spectral data proved the validity of the novel synthesized steroid derivatives. The cytotoxicity of the synthesized compounds 2, 5, 6, 7, 10, 11, 12, 14, 15, 17 were evaluated using human hepatocellular carcinoma cell lines (HepG2 and Huh-7) and non-small cell lung cancer (A549) cell lines. The synthesized compounds reported a remarkable gradual decrease in the cell viability of the three tested cancer cell lines. It was observed that compounds 2 and 12 had the lowest IC50s and the highest cytotoxic effects against all tested cell lines. As attempt to explain the cytotoxic activity achieved by the tested compounds in the in vitro study, molecular simulation was done to reveal the activity of the tested compounds against four different proteins (CDK2, CYP19, JAK2, and BCL2) which are highly implicated in cancer regulation and progression. We found that compound 2, and 12 were the best docked compounds against all tested receptors, which was indicated by lowest binding energy compared to reference ligand. Interestingly enough, our molecular study was in agreement with the cytotoxic activity. As future prospective, we are recommending further study on compounds 2, and 12 against the four different proteins to prove their mode of action.


Assuntos
Antineoplásicos/farmacologia , Simulação de Acoplamento Molecular , Esteroides/farmacologia , Células A549 , Antineoplásicos/síntese química , Antineoplásicos/química , Proliferação de Células/efeitos dos fármacos , Relação Dose-Resposta a Droga , Resistencia a Medicamentos Antineoplásicos/efeitos dos fármacos , Ensaios de Seleção de Medicamentos Antitumorais , Células Hep G2 , Humanos , Estrutura Molecular , Proteínas de Neoplasias/antagonistas & inibidores , Esteroides/síntese química , Esteroides/química , Relação Estrutura-Atividade , Células Tumorais Cultivadas
11.
Pancreatology ; 18(1): 94-99, 2018 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-29221632

RESUMO

PURPOSE: To retrospectively investigate the effectiveness of triple drug combination transarterial chemoembolization (TACE) on local tumor response and survival in patients with liver metastases from pancreatic cancer. Also, this study will evaluate the variances in response regarding the number of metastases, assess the correlation between tumor response and the changes in the apparent diffusion coefficients (ADC) in diffusion weighted (DW) MRI. MATERIALS AND METHODS: One hundred and twelve patients (58 men and 54 women; mean age 57) with malignant liver metastases from pancreatic adenocarcinoma underwent at least one session of TACE with a chemotherapeutic combination of mitomycin C, cisplatin, and gemcitabine. A size-based evaluation of tumor response (response evaluation criteria in solid tumors (RECIST)) was conducted, along with ADC values, and survival indices as related to treatment pattern. RESULTS: Four weeks following the end of the treatment, 78.26% of patients showed stable disease and 11.59% showed partial response. The median survival time was 19 months and for the stable disease group, 26 months. Low pretreatment ADC values showed no significant correlation to poor response to treatment (r = 0.347,p = 0.146). CONCLUSION: The triple drug TACE technique showed improvements in median survival times in patients with hepatic metastases from pancreatic carcinoma and helped control disease progression, whereas the number of hepatic lesions was not a statistically significant factor in patients' response to TACE. The data suggest that pre-treatment ADC values in DW-MRI have no statistical correlation with tumor response.


Assuntos
Adenocarcinoma/patologia , Quimioembolização Terapêutica , Neoplasias Hepáticas/secundário , Neoplasias Pancreáticas/patologia , Adenocarcinoma/diagnóstico por imagem , Adenocarcinoma/terapia , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Neoplasias Hepáticas/diagnóstico por imagem , Neoplasias Hepáticas/terapia , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Neoplasias Pancreáticas/terapia
12.
Ther Adv Endocrinol Metab ; 6(3): 87-91, 2015 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-26137212

RESUMO

BACKGROUND: Diabetes mellitus is a leading cause of morbidity and mortality among children across the world and is responsible for a growing proportion of global healthcare expenditure. However, limited data are available on lung dysfunction in children with diabetes. AIM: The aim of this study was to evaluate the pulmonary function changes in children with type 1 diabetes mellitus (T1DM). METHODS: We studied 60 children with T1DM (mean age 10.5 ± 2.32 years; disease duration 2.45 ± 0.6 years, and 50 healthy control children (mean age 9.9 ± 2.5 years). Spirometry was performed for all individuals to measure forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), FEV1/FVC ratio, and peak expiratory flow rate (PEFR). Glycemic control was assessed on the basis of glycated hemoglobin (HbA1c), with HbA1c values <8% considered to indicate good glycemic control, and HbA1c values ⩾8% to indicate poor control. RESULTS: There was significant reduction in all spirometeric parameters in diabetic children in comparison with healthy control children. Children with poor glycemic control had significant impairment in lung functions compared with those with good glycemic control. CONCLUSIONS: T1DM in children leads to impairment of lung functions and this impairment increases with poor glycemic control.

13.
Mediterr J Hematol Infect Dis ; 5(1): e2013028, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-23667726

RESUMO

OBJECTIVES: Recurrent/persistent pneumonia in children continues to be a major challenge for the pediatricians. The aim of our study was to establish the prevalence and underlying causes of recurrent/persistent pneumonia in children in Upper Egypt. SETTINGS: Assiut University Children Hospital, Assiut, Egypt. PATIENTS AND METHODS: Patients, admitted for pneumonia to the hospital during 2 years, were investigated with microbiological, biochemical, immunological and radiological tests in order to establish the prevalence of recurrent/persistent pneumonia and to find out its underlying causes. RESULTS: 113 out of 1228 patients (9.2%) met the diagnosis of recurrent/persistent pneumonia. Identified causes were; aspiration syndrome (17.7%), pulmonary TB (14.0%), congenital heart disease (11.5%), bronchial asthma (9.7%), immune deficiency disorders (8.8%) and vitamin D deficiency rickets (7.0%). Other causes included; congenital anomalies of the respiratory tract, interstitial lung diseases, bronchiectasis, and sickle cell anemia. No predisposing factors could be identified in 15% of cases. CONCLUSION: Approximately 1 out of 10 children with diagnosis of pneumonia in Assiut University Children Hospital had recurrent/persistent pneumonia. The most frequent underlying cause for recurrent/persistent pneumonia was aspiration syndrome, followed by pulmonary TB.

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