Pub Date : 2020-01-01DOI: 10.1080/20905068.2020.1779992
H. Verma, Y. K. Ratre, P. Mazzone, S. Laurino, L. Bhaskar
ABSTRACT Introduction In spite of the substantial advances in clinical practice, Gastric cancer (GC) remains the third leading cause of cancer death worldwide. The incidence of drug resistance remains a hindrance to effective treatment for GC. Although the molecular mechanisms of chemoresistance have broadly studied, the gene regulation and expression mechanisms of miRNA have not entirely understood. Methods Online databases of PubMed, Scopus, Google Scholar, and Embase databases were searched to retrieve relevant publications. The following keywords were used: MicroRNA, Non-coding RNA, miRNA, Gastric cancer, drug resistance, and chemoresistance. Results miRNAs play a pivotal role in the initiation, progression of tumor and metastasis, as well as in the development of pathways mediating resistance to chemotherapy in GC. Unluckily, to date, there is no consistent, reliable biomarker available to predict the response of chemotherapy before the start of the treatment. Discussion In this review, we would like to provide an overview of the miRNAs and miRNA facilitated chemoresistance machinery in GC to develop a personalized treatment to overcome GC drug resistance.
{"title":"Micro RNA facilitated chemoresistance in gastric cancer: a novel biomarkers and potential therapeutics","authors":"H. Verma, Y. K. Ratre, P. Mazzone, S. Laurino, L. Bhaskar","doi":"10.1080/20905068.2020.1779992","DOIUrl":"https://doi.org/10.1080/20905068.2020.1779992","url":null,"abstract":"ABSTRACT Introduction In spite of the substantial advances in clinical practice, Gastric cancer (GC) remains the third leading cause of cancer death worldwide. The incidence of drug resistance remains a hindrance to effective treatment for GC. Although the molecular mechanisms of chemoresistance have broadly studied, the gene regulation and expression mechanisms of miRNA have not entirely understood. Methods Online databases of PubMed, Scopus, Google Scholar, and Embase databases were searched to retrieve relevant publications. The following keywords were used: MicroRNA, Non-coding RNA, miRNA, Gastric cancer, drug resistance, and chemoresistance. Results miRNAs play a pivotal role in the initiation, progression of tumor and metastasis, as well as in the development of pathways mediating resistance to chemotherapy in GC. Unluckily, to date, there is no consistent, reliable biomarker available to predict the response of chemotherapy before the start of the treatment. Discussion In this review, we would like to provide an overview of the miRNAs and miRNA facilitated chemoresistance machinery in GC to develop a personalized treatment to overcome GC drug resistance.","PeriodicalId":7611,"journal":{"name":"Alexandria Journal of Medicine","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/20905068.2020.1779992","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46109757","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-01-01DOI: 10.1080/20905068.2020.1778417
H. Assaad, S. Assaad-Khalil
ABSTRACT Introduction As the coronavirus disease (COVID-19) spreads worldwide, awaiting the development of a vaccine, researchers are looking among the arsenal of available drugs, for a potential cure or medication to improve patients’ outcome. A highly elevated levels of cytokines in COVID-19 patients requiring ICU admission, has suggested that a “cytokine storm” was associated with disease severity. Methods We summarize published key findings about imatinib, aiming to rationalize its use as a potential pharmacologic treatment for COVID-19. Results Data from cellular, animal models and clinical trials, showed a beneficial role of tyrosine kinase inhibitors in the regulation of inflammation, the maintenance of endothelial barrier integrity, as well as the expression of antiviral properties. This data is especially derived from imatinib, the most studied Abl family kinase inhibitor, that is currently in clinical use for multiple medical conditions. Discussion Based on this encouraging data, we hypothesize that imatinib might be beneficial for the treatment of patients with SARS-CoV-2 pneumonia, in the aim of preventing disease progression into the severe phenotype of hypoxic respiratory failure and acute respiratory distress syndrome. This concept can be considered for evaluation in a randomized controlled study.
{"title":"Imatinib a Tyrosine Kinase Inhibitor: a potential treatment for SARS- COV-2 induced pneumonia","authors":"H. Assaad, S. Assaad-Khalil","doi":"10.1080/20905068.2020.1778417","DOIUrl":"https://doi.org/10.1080/20905068.2020.1778417","url":null,"abstract":"ABSTRACT Introduction As the coronavirus disease (COVID-19) spreads worldwide, awaiting the development of a vaccine, researchers are looking among the arsenal of available drugs, for a potential cure or medication to improve patients’ outcome. A highly elevated levels of cytokines in COVID-19 patients requiring ICU admission, has suggested that a “cytokine storm” was associated with disease severity. Methods We summarize published key findings about imatinib, aiming to rationalize its use as a potential pharmacologic treatment for COVID-19. Results Data from cellular, animal models and clinical trials, showed a beneficial role of tyrosine kinase inhibitors in the regulation of inflammation, the maintenance of endothelial barrier integrity, as well as the expression of antiviral properties. This data is especially derived from imatinib, the most studied Abl family kinase inhibitor, that is currently in clinical use for multiple medical conditions. Discussion Based on this encouraging data, we hypothesize that imatinib might be beneficial for the treatment of patients with SARS-CoV-2 pneumonia, in the aim of preventing disease progression into the severe phenotype of hypoxic respiratory failure and acute respiratory distress syndrome. This concept can be considered for evaluation in a randomized controlled study.","PeriodicalId":7611,"journal":{"name":"Alexandria Journal of Medicine","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/20905068.2020.1778417","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42551759","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-01-01DOI: 10.1080/20905068.2020.1747733
J. Haddad, M. A. Al Hyari, Monther S. Al Momani, Ahmad A. Al Omari, F. Ammari, Firas O. Annabi
ABSTRACT Introduction: Jordan has limited published data on T2DM and its treatment patterns. This analysis of the DISCOVER study, focusing on Jordan, is aimed at describing the characteristics of patients and treatment patterns according to the real-world setting in T2DM patients initiating a second-line antidiabetic treatment Methods: The DISCOVER study is an ongoing, multi-country, multicenter, observational, prospective, and longitudinal cohort study. The baseline data of patients’ characteristics, clinical and laboratory variables, micro- and macro-complications, and treatment choices were captured on a standardized case report form. Results: Two hundred and seventy-one patients were enrolled from 13 different clinical sites in Jordan. Sixty percent of the patients were male. The participants overall mean age was 53.8 ± 11.3 years with a mean BMI 30.8 ± 5.0 kg/m 2. The mean duration of T2DM was almost 6 years and the mean documented HbA1c and fasting plasma glucose were e 8.4% ± 1.6 and 180.9 ± 63.7 mg/dL, respectively, at the initiation of second-line antidiabetic treatment. Almost 25% of the participants were reported to be either current smokers or ex-smokers. More than 40% of patients had comorbidities such as hypertension or dyslipidemia. Diabetes related microvascular and macrovascular complications were documented in 10.3% and 12.5% of patients, respectively. Metformin (MET) alone was used as a first-line therapy in almost one-half of the patients and in combination with sulfonylurea (SU) in approximately one-third of the patients. The most commonly used second-line therapy was the combination of MET and dipeptidyl peptidase-4 inhibitors (DPP-4i) with 29.9% followed by the triple therapy of MET, SU, and DPP-4i with 28%. Conclusion: A substantial number of patients were young with uncontrolled diabetes and at high risk for micro- and macrovascular complications. Therefore, a comprehensive management with early treatment intensification and risk factors modifications are required to achieve target goals.
{"title":"Baseline characteristics and treatment pattern of type 2 diabetes patients in Jordan: analysis from the DISCOVER patient population","authors":"J. Haddad, M. A. Al Hyari, Monther S. Al Momani, Ahmad A. Al Omari, F. Ammari, Firas O. Annabi","doi":"10.1080/20905068.2020.1747733","DOIUrl":"https://doi.org/10.1080/20905068.2020.1747733","url":null,"abstract":"ABSTRACT Introduction: Jordan has limited published data on T2DM and its treatment patterns. This analysis of the DISCOVER study, focusing on Jordan, is aimed at describing the characteristics of patients and treatment patterns according to the real-world setting in T2DM patients initiating a second-line antidiabetic treatment Methods: The DISCOVER study is an ongoing, multi-country, multicenter, observational, prospective, and longitudinal cohort study. The baseline data of patients’ characteristics, clinical and laboratory variables, micro- and macro-complications, and treatment choices were captured on a standardized case report form. Results: Two hundred and seventy-one patients were enrolled from 13 different clinical sites in Jordan. Sixty percent of the patients were male. The participants overall mean age was 53.8 ± 11.3 years with a mean BMI 30.8 ± 5.0 kg/m 2. The mean duration of T2DM was almost 6 years and the mean documented HbA1c and fasting plasma glucose were e 8.4% ± 1.6 and 180.9 ± 63.7 mg/dL, respectively, at the initiation of second-line antidiabetic treatment. Almost 25% of the participants were reported to be either current smokers or ex-smokers. More than 40% of patients had comorbidities such as hypertension or dyslipidemia. Diabetes related microvascular and macrovascular complications were documented in 10.3% and 12.5% of patients, respectively. Metformin (MET) alone was used as a first-line therapy in almost one-half of the patients and in combination with sulfonylurea (SU) in approximately one-third of the patients. The most commonly used second-line therapy was the combination of MET and dipeptidyl peptidase-4 inhibitors (DPP-4i) with 29.9% followed by the triple therapy of MET, SU, and DPP-4i with 28%. Conclusion: A substantial number of patients were young with uncontrolled diabetes and at high risk for micro- and macrovascular complications. Therefore, a comprehensive management with early treatment intensification and risk factors modifications are required to achieve target goals.","PeriodicalId":7611,"journal":{"name":"Alexandria Journal of Medicine","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/20905068.2020.1747733","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44490007","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-01-01DOI: 10.1080/20905068.2020.1833278
A. Otovwe, Efegbere Henry Akpojubaro
ABSTRACT Introduction The prevalence of Diabetes Mellitus (DM) is currently reported to be on the increase in the school environment among teachers and students in Africa. This review highlighted the current state of DM in primary and secondary schools in Africa. Methods The review assessed critical literature on African Journals Online, Google Scholar search, PubMed, Medline, and Science Direct as well as information available about DM in the Africa continent. Relevant search terms included prevalence of DM in primary schools, the prevalence of DM in secondary schools, prevalence of DM among teachers and students, knowledge of DM among teachers and students, risk factors of DM among teachers and students in Africa. Results The review highlighted the prevalence of T2DM among teachers, while prediabetes and T1DM were reported among students. Furthermore, only two studies were identified to assessing knowledge of DM among teachers while few studies reported poor knowledge of DM among students. Conclusion The issue of DM in both primary and secondary schools should be given the needed attention by the concerned stakeholders. This is because of the possible escalation of T1DM and T2DM within the school environment in Africa in the nearest future.
{"title":"Diabetes mellitus in primary and secondary schools in Africa: an exploratory review","authors":"A. Otovwe, Efegbere Henry Akpojubaro","doi":"10.1080/20905068.2020.1833278","DOIUrl":"https://doi.org/10.1080/20905068.2020.1833278","url":null,"abstract":"ABSTRACT Introduction The prevalence of Diabetes Mellitus (DM) is currently reported to be on the increase in the school environment among teachers and students in Africa. This review highlighted the current state of DM in primary and secondary schools in Africa. Methods The review assessed critical literature on African Journals Online, Google Scholar search, PubMed, Medline, and Science Direct as well as information available about DM in the Africa continent. Relevant search terms included prevalence of DM in primary schools, the prevalence of DM in secondary schools, prevalence of DM among teachers and students, knowledge of DM among teachers and students, risk factors of DM among teachers and students in Africa. Results The review highlighted the prevalence of T2DM among teachers, while prediabetes and T1DM were reported among students. Furthermore, only two studies were identified to assessing knowledge of DM among teachers while few studies reported poor knowledge of DM among students. Conclusion The issue of DM in both primary and secondary schools should be given the needed attention by the concerned stakeholders. This is because of the possible escalation of T1DM and T2DM within the school environment in Africa in the nearest future.","PeriodicalId":7611,"journal":{"name":"Alexandria Journal of Medicine","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/20905068.2020.1833278","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49553103","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-01-01DOI: 10.1080/20905068.2020.1767529
M. Agha, M. Sallam, M. Eid
ABSTRACT Background Despite acute appendicitis is the most common underlying etiology of the acute abdomen, a considerable list of other pathologies should be considered; despite sharing almost the same clinical presentation. This study aimed to re-enhance the importance and sensitivity of CT scan as a solitary imaging tool, in the evaluation of patients with acute right lower abdominal pain. Patients and methods It is a retrospective study of the last 1000 patients, referred with acute right lower abdominal pain for CT scan examination. Biphasic CT scan abdomen protocol was applied for all. Results Cecal carcinoma was detected in three patients (0.3%), epiploic appendicitis in five (0.5%), omental infarct in two (0.2%), appendicular mucocele in two (0.2%), appendicular NET in one (0.1%), cecal diverticulitis in four (0.4%), Chron’s disease in six (0.6%), intussusception in one (0.1%) and FB in one (0.1%) and appendicular perforation in one (0.1%), acute simple appendicitis 398 (39.8%) and 577 (57.7%) were unremarkable. Conclusion Despite acute appendicitis is the most common cause of the acute abdomen, many other surgical and non-surgical etiologies should also be considered, with a higher sensitivity of CT as a solitary diagnostic tool of imaging.
{"title":"Beyond the commonest: right lower quadrant abdominal pain is not always appendicitis","authors":"M. Agha, M. Sallam, M. Eid","doi":"10.1080/20905068.2020.1767529","DOIUrl":"https://doi.org/10.1080/20905068.2020.1767529","url":null,"abstract":"ABSTRACT Background Despite acute appendicitis is the most common underlying etiology of the acute abdomen, a considerable list of other pathologies should be considered; despite sharing almost the same clinical presentation. This study aimed to re-enhance the importance and sensitivity of CT scan as a solitary imaging tool, in the evaluation of patients with acute right lower abdominal pain. Patients and methods It is a retrospective study of the last 1000 patients, referred with acute right lower abdominal pain for CT scan examination. Biphasic CT scan abdomen protocol was applied for all. Results Cecal carcinoma was detected in three patients (0.3%), epiploic appendicitis in five (0.5%), omental infarct in two (0.2%), appendicular mucocele in two (0.2%), appendicular NET in one (0.1%), cecal diverticulitis in four (0.4%), Chron’s disease in six (0.6%), intussusception in one (0.1%) and FB in one (0.1%) and appendicular perforation in one (0.1%), acute simple appendicitis 398 (39.8%) and 577 (57.7%) were unremarkable. Conclusion Despite acute appendicitis is the most common cause of the acute abdomen, many other surgical and non-surgical etiologies should also be considered, with a higher sensitivity of CT as a solitary diagnostic tool of imaging.","PeriodicalId":7611,"journal":{"name":"Alexandria Journal of Medicine","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/20905068.2020.1767529","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43334665","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-01-01DOI: 10.1080/20905068.2020.1851442
Shereif Ibrahim Salah Eldin Hegazy, Nasser Ahmed Gozlan, Hossam Elkafrawi, M. Elshafei, H. Kholosy
ABSTRACT Background: The quality of soft tissue reconstruction in upper and lower extremities caused by trauma, infection, burns, and tumor resection affects the patient function and esthetic outcome. Many flaps have been described in the literature to reconstruct such defects. Medial sural artery perforator flap is one of the options for reconstruction of upper and lower extremities. Patients and methods: Starting from July 2019 through August 2020, 20 pedicled and free MSAP flaps were used for reconstruction of upper and lower limbs soft tissue defects. Results: total flap loss occurred in two cases, partial flap loss occurred in two cases and the flap was abandoned in two cases. Otherwise, all flaps survived well. Conclusion: MSAP flap is an excellent option in the reconstruction of soft tissue defects in upper and lower extremities.
{"title":"Medial sural artery perforator flap in reconstruction of soft tissue defect in upper and lower extremities: a clinical study","authors":"Shereif Ibrahim Salah Eldin Hegazy, Nasser Ahmed Gozlan, Hossam Elkafrawi, M. Elshafei, H. Kholosy","doi":"10.1080/20905068.2020.1851442","DOIUrl":"https://doi.org/10.1080/20905068.2020.1851442","url":null,"abstract":"ABSTRACT Background: The quality of soft tissue reconstruction in upper and lower extremities caused by trauma, infection, burns, and tumor resection affects the patient function and esthetic outcome. Many flaps have been described in the literature to reconstruct such defects. Medial sural artery perforator flap is one of the options for reconstruction of upper and lower extremities. Patients and methods: Starting from July 2019 through August 2020, 20 pedicled and free MSAP flaps were used for reconstruction of upper and lower limbs soft tissue defects. Results: total flap loss occurred in two cases, partial flap loss occurred in two cases and the flap was abandoned in two cases. Otherwise, all flaps survived well. Conclusion: MSAP flap is an excellent option in the reconstruction of soft tissue defects in upper and lower extremities.","PeriodicalId":7611,"journal":{"name":"Alexandria Journal of Medicine","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/20905068.2020.1851442","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42920777","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-01-01DOI: 10.1080/20905068.2020.1714191
Osama M. Sobhey, Amal A Jouda, A. Metwally, N. Shawky, Mohammad N. Elkhashab
ABSTRACT Introduction : The Baveno VI consensus recommended the use of noninvasive predictors to identify patients at high risk of esophageal varices (EV) in whom endoscopic evaluation is most needed. Kallistatin is a protein molecule synthesized by the liver, and its level declines with the deterioration of liver functions. We aim to explore the role of kallistatin as a predictor of esophageal varices. Methods: This case–control study included 70 cirrhotic patients (35 patients with EV and 35 patients without EV). The laboratory investigations and upper GI endoscopy were performed, and the serum kallistatin level was measured in all patients. Results: The mean level of serum kallistatin was significantly lower in patients with varices (12.2 ± 5.6 vs 16.9 ± 4.8 µg/ml, p = 0.009). It also shows a significant decline in patients with large varices. Kallistatin can predict the presence of EV and large EV at cut off values of 15.8 and 8.9 µg/ml, respectively, with sensitivity and specificity of 71.4% and 54.3% for EV and 50% and 94.8% for large EV. Discussion : Kallistatin is a promising marker that can be used to predict the presence of esophageal varices especially when they are large and risky.
摘要简介：Baveno VI共识建议使用非侵入性预测因子来识别最需要内镜评估的食管静脉曲张（EV）高危患者。Kallistatin是一种由肝脏合成的蛋白质分子，其水平随着肝功能的恶化而下降。我们的目的是探讨kallistatin作为食管静脉曲张预测指标的作用。方法：本病例对照研究包括70例肝硬化患者（35例EV患者和35例非EV患者）。进行了实验室调查和上消化道内窥镜检查，并测量了所有患者的血清kallistatin水平。结果：静脉曲张患者血清kallistatin的平均水平显著降低（12.2±5.6 vs 16.9±4.8µg/ml，p=0.009）。大静脉曲张患者的血清kallistetin水平也显著下降。Kallistatin可以预测EV和大EV的存在，其截止值分别为15.8和8.9µg/ml，EV的敏感性和特异性分别为71.4%和54.3%，大EV的灵敏度和特异性为50%和94.8%。
{"title":"Evaluation of serum kallistatin level as a predictor of esophageal varices in cirrhotic patients","authors":"Osama M. Sobhey, Amal A Jouda, A. Metwally, N. Shawky, Mohammad N. Elkhashab","doi":"10.1080/20905068.2020.1714191","DOIUrl":"https://doi.org/10.1080/20905068.2020.1714191","url":null,"abstract":"ABSTRACT Introduction : The Baveno VI consensus recommended the use of noninvasive predictors to identify patients at high risk of esophageal varices (EV) in whom endoscopic evaluation is most needed. Kallistatin is a protein molecule synthesized by the liver, and its level declines with the deterioration of liver functions. We aim to explore the role of kallistatin as a predictor of esophageal varices. Methods: This case–control study included 70 cirrhotic patients (35 patients with EV and 35 patients without EV). The laboratory investigations and upper GI endoscopy were performed, and the serum kallistatin level was measured in all patients. Results: The mean level of serum kallistatin was significantly lower in patients with varices (12.2 ± 5.6 vs 16.9 ± 4.8 µg/ml, p = 0.009). It also shows a significant decline in patients with large varices. Kallistatin can predict the presence of EV and large EV at cut off values of 15.8 and 8.9 µg/ml, respectively, with sensitivity and specificity of 71.4% and 54.3% for EV and 50% and 94.8% for large EV. Discussion : Kallistatin is a promising marker that can be used to predict the presence of esophageal varices especially when they are large and risky.","PeriodicalId":7611,"journal":{"name":"Alexandria Journal of Medicine","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/20905068.2020.1714191","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49647718","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-01-01DOI: 10.1080/20905068.2020.1728881
Tayseer M. Zayton, E. El-reweny, H. Tammam, K. M. Gharbeya
ABSTRACT Introduction: Increasing use of extracorporeal membrane oxygenation (ECMO) for acute respiratory failure may increase resource requirements and hospital costs. Prediction of successful weaning in these patients may improve resource use and patients outcome. The Respiratory ECMO Survival Prediction (RESP) score has been proposed as an outcome prediction tool for patients undergoing venovenous (VV-ECMO). However, it was developed and validated on patients established on ECMO. This may limit its usefulness as an adjunct tool for decision-making process at the pre-ECMO stage. Aim: The aim of the work was to assess the efficacy of RESP score as a tool to predict successful weaning in patients treated with VV-ECMO before initiation of treatment. Patients and methods: The study was carried out on 23 adult patients who were admitted to the units of Critical Care Medicine Departments in Egyptian Armed Forces Hospitals within 1 year and were treated with VV-ECMO; all of them received the same treatment as recommended by ELSO guidelines for adult respiratory failure. They were classified into two groups according to ECMO weaning successfulness at the end of the study: group I (successful weaning) and group II (failed weaning). Complete physical assessment, laboratory investigations, and RESP score calculation were done before ECMO initiation. Results: Pre-ECMO RESP score, in group I it ranged from −8 to 7 (mean 1.75 ± 3.65), while in group II it ranged from −11 to 1 (mean −6.38 ± 1.88), there was statistically significant difference between the two groups (p = 0. 003). The ROC curve of RESP score showed an AUC of 0.880 (95% CI 0.658–0.981) (p < 0.001). The best cutoff value was −1, at that level the sensitivity was 69.7%, specificity was 81.5%. Calculated positive predictive value of RESP score was 88.9% while negative predictive value was 63.6%. Conclusion: RESP score may be effective tool to predict ECMO weaning successfulness before initiation of ECMO.
{"title":"Predicting successful weaning in patients treated with venovenous extracorporeal membrane oxygenation","authors":"Tayseer M. Zayton, E. El-reweny, H. Tammam, K. M. Gharbeya","doi":"10.1080/20905068.2020.1728881","DOIUrl":"https://doi.org/10.1080/20905068.2020.1728881","url":null,"abstract":"ABSTRACT Introduction: Increasing use of extracorporeal membrane oxygenation (ECMO) for acute respiratory failure may increase resource requirements and hospital costs. Prediction of successful weaning in these patients may improve resource use and patients outcome. The Respiratory ECMO Survival Prediction (RESP) score has been proposed as an outcome prediction tool for patients undergoing venovenous (VV-ECMO). However, it was developed and validated on patients established on ECMO. This may limit its usefulness as an adjunct tool for decision-making process at the pre-ECMO stage. Aim: The aim of the work was to assess the efficacy of RESP score as a tool to predict successful weaning in patients treated with VV-ECMO before initiation of treatment. Patients and methods: The study was carried out on 23 adult patients who were admitted to the units of Critical Care Medicine Departments in Egyptian Armed Forces Hospitals within 1 year and were treated with VV-ECMO; all of them received the same treatment as recommended by ELSO guidelines for adult respiratory failure. They were classified into two groups according to ECMO weaning successfulness at the end of the study: group I (successful weaning) and group II (failed weaning). Complete physical assessment, laboratory investigations, and RESP score calculation were done before ECMO initiation. Results: Pre-ECMO RESP score, in group I it ranged from −8 to 7 (mean 1.75 ± 3.65), while in group II it ranged from −11 to 1 (mean −6.38 ± 1.88), there was statistically significant difference between the two groups (p = 0. 003). The ROC curve of RESP score showed an AUC of 0.880 (95% CI 0.658–0.981) (p < 0.001). The best cutoff value was −1, at that level the sensitivity was 69.7%, specificity was 81.5%. Calculated positive predictive value of RESP score was 88.9% while negative predictive value was 63.6%. Conclusion: RESP score may be effective tool to predict ECMO weaning successfulness before initiation of ECMO.","PeriodicalId":7611,"journal":{"name":"Alexandria Journal of Medicine","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/20905068.2020.1728881","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45231082","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-01-01DOI: 10.1080/20905068.2020.1790957
I. Anwar, Eman Kamal El-dien Anwer, M. Abdallah
Dear Sir, Coronavirus disease-19 (COVID-19) is a pandemic disease which is caused by SARS-CoV2 virus. It is one of the biggest single-stranded positive-sense RNA viruses. SARS-CoV2 RNA dependent RN...
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Pub Date : 2020-01-01DOI: 10.1080/20905068.2020.1863040
W. Shehab-Eldin, M. Shaaban, Mai Abdel Samed Atia, S. Zewain
ABSTRACT Introduction: Malnutrition is common in patients with End-Stage Renal Disease (ESRD) on hemodialysis (HD) which significantly affects their quality of life. ESRD is associated with thyroid dysfunction which may affect morbidity and mortality. Changes in thyroid function in this population could be a marker of malnutrition. Our aim was the assessment of the nutritional status of patients with ESRD on HD and its association with thyroid function. Methods: A cross-sectional study was conducted on 84 patients with ESRD on HD. Nutritional status was assessed by anthropometric measurements and Subjective Global Assessment (SGA) Score. Serum FT3, FT4, and TSH concentrations were determined. CBC, kidney function tests, serum albumin, serum iron, total iron-binding capacity, serum cholesterol, and CRP were measured. Patients’ comorbidity status was determined using the Charlson Comorbidity Index (CCI). Results: The mean SGA score for studied patients was 13.73 ± 4.4, mean values of thyroid functions were: TSH 2.99 ± 2.93uIU/ml; FT4 1.08 ± 0.21 ng/dl and FT3 2.55 ± 0.52 pg/ml. According to SGA score, 26.2% of patients had normal nutritional status, 69% had mild to moderate malnutrition and 4.8% had severe malnutrition. SGA had significant negative correlation with FT3, while there was no significant correlation between it and FT4 or TSH. Serum FT3 concentration inversely correlated with age (r = −0.25, P= 0.02), CCI (r = −0.48, P= 0.0001), CRP (r = −0.46, P= 0.0001), and SGA (r = −0.49, P= 0.0001), and positively correlated with serum albumin (r = 0.47, P= 0.0001). In multivariate regression analysis, SGA was independently associated with FT3 (β, −1.36; 95% confidence interval, −2.5 to −0.2, P= 0.02) Conclusions: Malnutrition is prevalent among patients with ESRD on HD. FT3 is a marker of malnutrition and could be used as an accessible and reproducible periodical method to detect such states.
{"title":"The association between thyroid function and nutritional status in patients with end-stage renal disease on hemodialysis","authors":"W. Shehab-Eldin, M. Shaaban, Mai Abdel Samed Atia, S. Zewain","doi":"10.1080/20905068.2020.1863040","DOIUrl":"https://doi.org/10.1080/20905068.2020.1863040","url":null,"abstract":"ABSTRACT Introduction: Malnutrition is common in patients with End-Stage Renal Disease (ESRD) on hemodialysis (HD) which significantly affects their quality of life. ESRD is associated with thyroid dysfunction which may affect morbidity and mortality. Changes in thyroid function in this population could be a marker of malnutrition. Our aim was the assessment of the nutritional status of patients with ESRD on HD and its association with thyroid function. Methods: A cross-sectional study was conducted on 84 patients with ESRD on HD. Nutritional status was assessed by anthropometric measurements and Subjective Global Assessment (SGA) Score. Serum FT3, FT4, and TSH concentrations were determined. CBC, kidney function tests, serum albumin, serum iron, total iron-binding capacity, serum cholesterol, and CRP were measured. Patients’ comorbidity status was determined using the Charlson Comorbidity Index (CCI). Results: The mean SGA score for studied patients was 13.73 ± 4.4, mean values of thyroid functions were: TSH 2.99 ± 2.93uIU/ml; FT4 1.08 ± 0.21 ng/dl and FT3 2.55 ± 0.52 pg/ml. According to SGA score, 26.2% of patients had normal nutritional status, 69% had mild to moderate malnutrition and 4.8% had severe malnutrition. SGA had significant negative correlation with FT3, while there was no significant correlation between it and FT4 or TSH. Serum FT3 concentration inversely correlated with age (r = −0.25, P= 0.02), CCI (r = −0.48, P= 0.0001), CRP (r = −0.46, P= 0.0001), and SGA (r = −0.49, P= 0.0001), and positively correlated with serum albumin (r = 0.47, P= 0.0001). In multivariate regression analysis, SGA was independently associated with FT3 (β, −1.36; 95% confidence interval, −2.5 to −0.2, P= 0.02) Conclusions: Malnutrition is prevalent among patients with ESRD on HD. FT3 is a marker of malnutrition and could be used as an accessible and reproducible periodical method to detect such states.","PeriodicalId":7611,"journal":{"name":"Alexandria Journal of Medicine","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/20905068.2020.1863040","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42355579","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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