Publications by authors named "Mohamed Ahmed"

1,099 Publications

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Epidemiological characterization and geographic distribution of human immunodeficiency virus/acquired immunodeficiency syndrome infection in North African countries.

World J Virol 2021 Mar;10(2):69-85

Department of Microbiology and Parasitology, Faculty of Veterinary Medicine, University of Tripoli, Tripoli cc82668, Tripoli, Libya.

Background: Human immunodeficiency virus (HIV) infection is a major global public health concern North African countries carry a disproportionate burden of HIV representing one of the highest rates in Africa.

Aim: To characterize the epidemiological and spatial trends of HIV infection in this region.

Methods: A systematic review was carried out on all the published data regarding HIV/acquired immunodeficiency syndrome in North African countries over ten years (2008-2017) following the PRISMA guidelines. We performed a comprehensive literature search using Medline PubMed, Embase, regional and international databases, and country-level reports with no language restriction. The quality, quantity, and geographic coverage of the data were assessed at both the national and regional levels. We used random-effects methods, spatial variables, and stratified results by demographic factors. Only original data on the prevalence of HIV infection were included and independently evaluated by professional epidemiologists.

Results: A total of 721 records were identified but only 41 that met the criteria were included in the meta-analysis. There was considerable variability in the prevalence estimates of HIV within the countries of the region. The overall prevalence of HIV ranged from 0.9% [95% confidence interval (CI) 0.8-1.27] to 3.8% (95%CI 1.17-6.53). The highest prevalence was associated with vulnerable groups and particularly drug abusers and sexually promiscuous individuals. The dense HIV clustering noted varied from one country to another. At least 13 HIV subtypes and recombinant forms were prevalent in the region. Subtype B was the most common variant, followed by CRF02_AG.

Conclusion: This comprehensive review indicates that HIV infection in North African countries is an increasing threat. Effective national and regional strategies are needed to improve monitoring and control of HIV transmission, with particular emphasis on geographic variability and HIV clustering.
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http://dx.doi.org/10.5501/wjv.v10.i2.69DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7995411PMC
March 2021

Nourin-Associated miRNAs: Novel Inflammatory Monitoring Markers for Cyclocreatine Phosphate Therapy in Heart Failure.

Int J Mol Sci 2021 Mar 30;22(7). Epub 2021 Mar 30.

Department of Pharmacology and Toxicology, Faculty of Pharmacy, Cairo University, Cairo 11562, Egypt.

Background: Cyclocreatine phosphate (CCrP) is a potent bioenergetic cardioprotective compound known to preserve high levels of cellular adenosine triphosphate during ischemia. Using the standard Isoproterenol (ISO) rat model of heart failure (HF), we recently demonstrated that the administration of CCrP prevented the development of HF by markedly reducing cardiac remodeling (fibrosis and collagen deposition) and maintaining normal ejection fraction and heart weight, as well as physical activity. The novel inflammatory mediator, Nourin is a 3-KDa formyl peptide rapidly released by ischemic myocardium and is associated with post-ischemic cardiac inflammation. We reported that the Nourin-associated (marker of cell damage) and (marker of inflammation) are significantly upregulated in unstable angina patients and patients with acute myocardial infarction, but not in healthy subjects.

Objectives: To test the hypothesis that Nourin-associated and are upregulated in ISO-induced "HF rats" and that the administration of CCrP prevents myocardial injury (MI) and reduces Nourin gene expression in "non-HF rats".

Methods: 25 male Wistar rats (180-220 g) were used: ISO/saline ( = 6), ISO/CCrP (0.8 g/kg/day) ( = 5), control/saline ( = 5), and control/CCrP (0.8 g/kg/day) ( = 4). In a limited study, CCrP at a lower dose of 0.4 g/kg/day ( = 3) and a higher dose of 1.2 g/kg/day ( = 2) were also tested. The Rats were injected SC with ISO for two consecutive days at doses of 85 and 170 mg/kg/day, respectively, then allowed to survive for an additional two weeks. CCrP and saline were injected IP (1 mL) 24 h and 1 h before first ISO administration, then daily for two weeks. Serum CK-MB (U/L) was measured 24 h after the second ISO injection to confirm myocardial injury. After 14 days, gene expression levels of and were measured in serum samples using quantitative real-time PCR (qPCR).

Results: While high levels of CK-MB were detected after 24 h in the ISO/saline rats indicative of MI, the ISO/CCrP rats showed normal CK-MB levels, supporting prevention of MI by CCrP. After 14 days, gene expression profiles showed significant upregulation of and by 8.6-fold and 8.7-fold increase, respectively, in the ISO/saline rats, "HF rats," compared to the control/saline group. On the contrary, CCrP treatment at 0.8 g/kg/day markedly reduced gene expression of miR-137 by 75% and of by 44% in the ISO/CCrP rats, "non-HF rats," compared to the ISO/Saline rats, "HF rats." Additionally, healthy rats treated with CCrP for 14 days showed no toxicity in heart, liver, and renal function.

Conclusions: Results suggest a role of Nourin-associated and in the pathogenesis of HF and that CCrP treatment prevented ischemic injury in "non-HF rats" and significantly reduced Nourin gene expression levels in a dose-response manner. The Nourin gene-based mRNAs may, therefore, potentially be used as monitoring markers of drug therapy response in HF, and CCrP-as a novel preventive therapy of HF due to ischemia.
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http://dx.doi.org/10.3390/ijms22073575DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8036979PMC
March 2021

IoT Data Qualification for a Logistic Chain Traceability Smart Contract.

Sensors (Basel) 2021 Mar 23;21(6). Epub 2021 Mar 23.

Samovar, Télécom SudParis, Institut Polytechnique de Paris, 9 rue Charles Fourier, 91011 Evry-Courcouronnes CEDEX, France.

In the logistic chain domain, the traceability of in their entire delivery process from the to the involves many stakeholders. From the traceability data, contractual decisions may be taken such as incident detection, validation of the delivery or billing. The stakeholders require transparency in the whole process. The combination of the Internet of Things (IoT) and the blockchain paradigms helps in the development of automated and trusted systems. In this context, ensuring the quality of the IoT data is an absolute requirement for the adoption of those technologies. In this article, we propose an approach to assess the data quality (DQ) of IoT data sources using a logistic traceability smart contract developed on top of a blockchain. We select the quality dimensions relevant to our context, namely accuracy, completeness, consistency and currentness, with a proposition of their corresponding measurement methods. We also propose a data quality model specific to the logistic chain domain and a distributed traceability architecture. The evaluation of the proposal shows the capacity of the proposed method to assess the IoT data quality and ensure the user agreement on the data qualification rules. The proposed solution opens new opportunities in the development of automated logistic traceability systems.
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http://dx.doi.org/10.3390/s21062239DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8005206PMC
March 2021

An Overview on Synthetic 2-Aminothiazole-Based Compounds Associated with Four Biological Activities.

Molecules 2021 Mar 7;26(5). Epub 2021 Mar 7.

Department of Community Health Sciences, College of Applied Medical Sciences, King Saud University, P.O. Box 10219, Riyadh 11433, Saudi Arabia.

Amongst sulfur- and nitrogen-containing heterocyclic compounds, the 2-aminothiazole scaffold is one of the characteristic structures in drug development as this essential revelation has several biological activities abiding it to act as an anticancer, antioxidant, antimicrobial and anti-inflammatory agent, among other things. Additionally, various 2-aminothiazole-based derivatives as medical drugs have been broadly used to remedy different kinds of diseases with high therapeutic influence, which has led to their wide innovations. Owing to their wide scale of biological activities, their structural variations have produced attention amongst medicinal chemists. The present review highlights the recently synthesized 2-aminothiazole-containing compounds in the last thirteen years (2008-2020). The originality of this proposal is based on the synthetic strategies developed to access the novel 2-aminothiazole derivatives (-substituted, 3-substituted, 4-substituted, multi-substituted, aryl/alkyl substituents or acyl/other substituents). The literature reports many synthetic pathways of these 2-aminothiazoles associated with four different biological activities (anticancer, antioxidant, antimicrobial and anti-inflammatory activities). It is wished that this review will be accommodating for new views in the expedition for rationalistic designs of 2-aminothiazole-based medical synthetic pathways.
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http://dx.doi.org/10.3390/molecules26051449DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7962134PMC
March 2021

Antibiotic Use and Resistance Among Prescribers: Current Status of Knowledge, Attitude, and Practice in Egypt.

Infect Drug Resist 2021 25;14:1209-1218. Epub 2021 Mar 25.

Medical Microbiology and Immunology, Faculty of Medicine, Zagazig University, Zagazig, Egypt.

Introduction: The problem of antimicrobial resistance (AMR) is rising worldwide. One of the most significant factors influencing antimicrobial resistance in low- and middle-income countries is the lack of the skills and knowledge of health care providers for proper antimicrobial use.

Aim: To identify knowledge, characterize practices and describe the attitude of Egyptian prescribers towards antibiotic use.

Methods: A self-administered validated questionnaire was distributed among Egyptian prescribers.

Results: Five hundred Egyptian physicians responded to the questionnaire, 113 (22.6%) reported having Antibiotic Stewardship Program (ASP) at their workplace, 99 (19.8%) use international antibiotic guidelines as the main source for prescribing activity, 358 (71.6%) recorded adequate knowledge. Elder prescribers and those who work in private or university hospitals were significantly more knowledgeable (p=0.031 and 0.001, respectively). Forty-seven (9.4%) showed a positive attitude towards proper antibiotic prescription. The type of work institution; primary health clinics and private, or university hospital and the specialty are significantly associated with a positive attitude (p=0.009 and 0.015, respectively). Seventy-eight (15.6%) expressed a proper antibiotic prescription practice. Elder age, more experienced and trained prescribers showed more proper practice. The implementation of ASP and using proper sources of information were significantly associated with proper practice (p=0.012 and 0.008, respectively).

Conclusion: Egyptian prescribers have a good level of knowledge about antibiotics. However, low rates of positive attitude and proper practice towards the problem of AMR and ASP are recorded.
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http://dx.doi.org/10.2147/IDR.S299453DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8007586PMC
March 2021

Chronic Erosion of a Thoracic Stent Graft Through the Left Subclavian Artery.

Eur J Vasc Endovasc Surg 2021 Mar 27. Epub 2021 Mar 27.

German Aortic Centre, Department of Vascular Medicine, University Heart &Vascular Centre, Hamburg, Germany.

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http://dx.doi.org/10.1016/j.ejvs.2021.02.033DOI Listing
March 2021

Diagnosis of vascular catastrophe using optical coherence tomography.

Eur Heart J 2021 Mar 29. Epub 2021 Mar 29.

Department of Cardiology, James Cook University Hospital, Middlesbrough,UK.

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http://dx.doi.org/10.1093/eurheartj/ehab194DOI Listing
March 2021

Management considerations for a critically ill 26-gestational week patient with COVID-19: A case report.

Clin Case Rep 2021 Mar 4;9(3):1721-1724. Epub 2021 Feb 4.

Medical Intensive Care Department Hazm Mebaireek General Hospital (HMGH) Hamad Medical Corporation (HMC) Doha Qatar.

Pregnant women are potentially more susceptible to respiratory tract infections making them a high-risk group. We describe the successful management of a 35-year-old pregnant woman, G3, P1, with a history of a cesarean section who tested positive for COVID-19 at 26 weeks and required critical care support.
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http://dx.doi.org/10.1002/ccr3.3886DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7981732PMC
March 2021

Prognosis of spinal infections managed by minimal debridement: A case series in two tertiary centers.

Surg Neurol Int 2021 2;12:83. Epub 2021 Mar 2.

Department of Neurosurgery, Kasr Alainy Faculty of Medicine, Cairo University, Cairo, Egypt.

Background: Spinal infections can be challenging in their management and include spondylitis, epidural abscess, and spondylodiscitis. Usual treatment is conservative through antimicrobials or surgery to decompress neural tissue, debride all infected tissues, and fix if needed. We propose the concept of surgery without formal debridement aiming at neural protection.

Methods: The study was performed at two tertiary centers on 25 patients with clinical findings. One patient was treated conservatively and the rest surgically by laminectomy and fixation if needed. Evacuation of fluid pus was performed. In the cervical and the thoracic region, if the granulation tissue was anterior to the cord, only decompression by laminectomy was done.

Results: Low back pain was present in 22 cases (88%), 16 cases (64%) had lower limb pain, and 12 cases (48%) had weakness. The level of spinal infection was lumbar in 15 cases (60%), thoracic in 9 cases (36%) cases, and cervical in 1 case (4%). The type of infection was epidural abscess in 20 cases (80%), discitis in 16 cases (64%), and vertebral osteomyelitis in 12 cases (48%). Laminectomy was performed in 20 cases (80%) and fixation in 17 cases (68%). The symptoms improved in all cases. On follow-up, the lesion was reduced in 14 patients (56%) and disappeared in 11 cases (44%). One case required ventriculoperitoneal shunt placement due to postinfectious hydrocephalus.

Conclusion: Dealing with spinal infections surgically through decompression or fixation with minimal debridement of infected tissue appears to be a safe and effective method of management.
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http://dx.doi.org/10.25259/SNI_29_2021DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7982097PMC
March 2021

SARS-CoV-2 vaccination modelling for safe surgery to save lives: data from an international prospective cohort study.

Authors:

Br J Surg 2021 Mar 24. Epub 2021 Mar 24.

Background: Preoperative SARS-CoV-2 vaccination could support safer elective surgery. Vaccine numbers are limited so this study aimed to inform their prioritization by modelling.

Methods: The primary outcome was the number needed to vaccinate (NNV) to prevent one COVID-19-related death in 1 year. NNVs were based on postoperative SARS-CoV-2 rates and mortality in an international cohort study (surgical patients), and community SARS-CoV-2 incidence and case fatality data (general population). NNV estimates were stratified by age (18-49, 50-69, 70 or more years) and type of surgery. Best- and worst-case scenarios were used to describe uncertainty.

Results: NNVs were more favourable in surgical patients than the general population. The most favourable NNVs were in patients aged 70 years or more needing cancer surgery (351; best case 196, worst case 816) or non-cancer surgery (733; best case 407, worst case 1664). Both exceeded the NNV in the general population (1840; best case 1196, worst case 3066). NNVs for surgical patients remained favourable at a range of SARS-CoV-2 incidence rates in sensitivity analysis modelling. Globally, prioritizing preoperative vaccination of patients needing elective surgery ahead of the general population could prevent an additional 58 687 (best case 115 007, worst case 20 177) COVID-19-related deaths in 1 year.

Conclusion: As global roll out of SARS-CoV-2 vaccination proceeds, patients needing elective surgery should be prioritized ahead of the general population.
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http://dx.doi.org/10.1093/bjs/znab101DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7995808PMC
March 2021

Endoscopic Robotic Retrieval of a Migrated Subclavian Vein Stent from the Right Ventricle.

Innovations (Phila) 2021 Mar 23:1556984520986656. Epub 2021 Mar 23.

13713773422646 Department of Surgery, Division of Cardiothoracic Surgery, Emory Saint Joseph's Hospital, Emory University School of Medicine, Atlanta, GA, USA.

A 54-year-old woman with end-stage renal disease on hemodialysis with access through a right arm arteriovenous fistula presented with right arm swelling. Venography demonstrated right subclavian vein stenosis. A balloon angioplasty of the stenotic vein was unsuccessful, and she subsequently underwent stent placement with balloon angioplasty. Ten days following the procedure, she developed acute shortness of breath. Transthoracic echocardiogram demonstrated the migration of the venous stent into the right ventricle. Using an endoscopic robotic approach, the stent was successfully extracted from the beating heart.
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http://dx.doi.org/10.1177/1556984520986656DOI Listing
March 2021

Supramolecular Self-Assembly Built by Weak Hydrogen, Chalcogen, and Unorthodox Nonbonded Motifs in 4-(4-Chlorophenyl)-3-[(4-fluorobenzyl)sulfanyl]-5-(thiophen-2-yl)-4-1,2,4-triazole, a Selective COX-2 Inhibitor: Insights from X-ray and Theoretical Studies.

ACS Omega 2021 Mar 3;6(10):6996-7007. Epub 2021 Mar 3.

Biomolecular Crystallography Laboratory, Department of Bioinformatics, School of Chemical and Biotechnology, SASTRA Deemed University, Thanjavur 613 401, India.

A selective triazole-based COX-2 inhibitor, 4-(4-chlorophenyl)-3-[(4-fluorobenzyl)sulfanyl]-5-(thiophen-2-yl)-4-1,2,4-triazole, CHClFNS, has been synthesized, and its crystal structure was determined at 150 K. Single-crystal X-ray diffraction analysis revealed that the thiophene ring was disordered over two orientations. The crystal structure is stabilized by weak hydrogen and chalcogen bonds and unorthodox F···π and S···C(π) contacts. These noncovalent interactions cooperatively generate the supramolecular self-assembly in the crystalline state. The Hirshfeld surface and its associated two-dimensional (2D)-fingerprint plots were obtained to analyze the role of different noncovalent interactions in the crystal packing. Further, the enrichment ratio was obtained from different atom···atom pairs to calculate the propensity of these pairs to form noncovalent interactions. The strength of different dimeric motifs formed in the crystal structure and lattice energies was calculated by the PIXEL method. Furthermore, the topological analysis of the charge density of intermolecular interactions was described. A CSD survey of C-H···F hydrogen bond, C-S···Cl chalcogen bond, and unorthodox nonbonded contacts (F···π and S···C(π)) is presented. The title compound possesses selective inhibitory activity against human COX-2 enzyme rather than COX-1. The quantum mechanics (QM) polarized ligand docking analysis was used to predict the binding pose and study the title compound's selectivity against COX-1/2 enzymes.
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http://dx.doi.org/10.1021/acsomega.0c06287DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7970574PMC
March 2021

Oligometastatic prostatic cancer recurrence: role of salvage lymph node dissection (sLND) and radiation therapy-stereotactic body radiation therapy (RT-SBRT).

Curr Opin Urol 2021 May;31(3):199-205

Department of Urology.

Purpose Of Review: Metastases directed therapy (MDT) is an increasingly utilized modality in patients with oligometastatic prostate cancer (OMPC) recurrence. The purpose of our review is to discuss the recent literature on the safety and oncologic outcomes of this treatment approach.

Recent Findings: Metastases directed therapy, in particular, stereotactic body radiation therapy (SBRT) and salvage lymph node dissection (sLND), has shown promising efficacy in patients with OMPC. Many case series report favorable outcomes with MDT as compared to hormonal deprivation therapy alone or surveillance. Of the few case series investigating the use of MDT as part of a multimodality approach in castrate-resistant OMPC, more favorable outcomes in comparison to the use of systemic treatment alone are reported.

Summary: With the recent advances in imaging techniques, particularly molecular imaging, management of OMPC has progressed rapidly in the last few years. The feasibility and benefits of MDT in OMPC have been demonstrated in prospective and retrospective series. Further prospective studies investigating the role of MDT to define optimal patient subgroups and management strategies are warranted.
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http://dx.doi.org/10.1097/MOU.0000000000000865DOI Listing
May 2021

An Assessment of Health Priorities Among a Community Sample of Somali Adults.

J Immigr Minor Health 2021 Mar 19. Epub 2021 Mar 19.

Department of Medicine, Mayo Clinic, 200 1st Street SW, Rochester, MN, 55905, USA.

Somali immigrants are one of the largest African populations to resettle in the United States since 1990. There is an emerging literature base of disease-specific studies among Somali immigrants. However, we are aware of no studies on the health priorities for Somalis from the community's perspective. Somali adults in Minnesota completed a survey conducted by a community-based participatory research partnership on individual and community health priorities. Data were reported as counts and frequencies. 646 participants completed the survey. The most important health issues for individuals and their families were health behaviors (22.7%), diabetes (18.2%), and hypertension (14.4%), while those of the community were diabetes (22.5%), hypertension (18.8%) and weight (15.9%). This study found a significant overlap of health priorities among Somali individuals and their families compared to the community. These health priorities underscore the need to focus on non-communicable diseases among Somali immigrants.
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http://dx.doi.org/10.1007/s10903-021-01166-yDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7975235PMC
March 2021

Is the Antioxidant Capacity of Stored Human Milk Preserved?

Breastfeed Med 2021 Mar 15. Epub 2021 Mar 15.

Neonatal-Perinatal Medicine, Cohen Children's Medical Center, New Hyde Park, New York, USA.

In the neonatal intensive care unit (NICU) expressed mothers' milk usually is stored frozen until used. We found that when human milk was stored at -20°C for up to 9 months there were reduced bacterial counts and pH, increased free fatty acids, but unchanged immune proteins. Antioxidant protection is an important benefit of human milk. Few studies have evaluated long-term effects of cold storage on the antioxidant capacity of human milk. We hypothesized that the antioxidant capacity of human milk is affected adversely by long-term storage at -20°C. To study the impact of long-term cold storage on the oxidative capacity of human milk and the biological impact of these changes on macromolecular constituents of human milk. Freshly expressed milk was obtained from mothers in the NICU, stored at -20°C for 6 months, and compared with the baseline. Paired samples were analyzed for glutathione, hydrogen peroxide (HO), 8-isoprostane, catalase, and superoxide dismutase. There was no change in HO concentration between baseline and 6 months. Significant reductions from baseline in both catalase and superoxide dismutase concentrations and activities, total glutathione, oxidized glutathione, reduced glutathione, and the ratio of reduced to oxidized glutathione were observed ( < 0.05). There was a significant increase in 8-isoprostane concentrations ( < 0.001). These data indicate significant changes in antioxidant capacity of human milk, including oxidation of macromolecules, after storage at -20°C for 6 months. The clinical implication of these findings may explain the nonuniform protection against oxidant disease in preterm infants fed human milk.
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http://dx.doi.org/10.1089/bfm.2020.0407DOI Listing
March 2021

Feasibility Study of Vascularized Composite Urinary Bladder Allograft Transplantation (VCA) in a Cadaver Model.

J Urol 2021 Mar 8:101097JU0000000000001699. Epub 2021 Mar 8.

Department of Urology, Mayo Clinic, Rochester, Minnesota.

Introduction: Severe Urinary Bladder dysfunction may lead to secondary renal injury either from increased pressures, urine reflux or recurrent urinary tract infections. Previous attempts at generating bladder tissue substitutes have failed and using intestinal segments for reconstruction carries certain risks. Therefore there is a need for better options for these patients Vascular composite allograft (VCA) transplants have been success in the past decade and have included limb, penile and uterine transplants.

Objective: The purpose of this study was to establish the feasibility of performing a urinary bladder vascularized composite allograft (VCA) transplant for either bladder augmentation or neobladder creation.

Study Design: Six adult cadavers were studied. Cadavers were excluded for any previous pelvic surgery, radiation, vascular surgery or history of pelvic malignancy. An intravascular colored silicone and barium mixture was injected and both CT scans and gross dissections were performed. Contrast enhanced CT imaging was used to delineate urinary bladder vascular anatomy variability. Bladders were explanted from two cadavers with bilateral vascular pedicles based on the external iliac vessels and "transplanted" to replicate a bladder transplant.

Results: Contrast enhanced 3D-CT reconstructions and cadaver dissections revealed distal vascular variability with proximal blood supply based primarily on the internal iliac artery. Urinary bladder VCA was successfully performed during 2 mock transplants with the vascular anastomosis done to the recipient external iliac artery and vein.

Conclusion: Urinary bladder vascularized composite allograft transplant is technically and anatomically feasible. This procedure may obviate the use of intestinal segments for bladder reconstruction in select patients. A phase 1 clinical trial is in progress.
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http://dx.doi.org/10.1097/JU.0000000000001699DOI Listing
March 2021

A Modification to Enhance the Survival of the Island FDMA Flap by Adding a Skin Bridge.

Plast Reconstr Surg Glob Open 2021 Feb 17;9(2):e3434. Epub 2021 Feb 17.

Plastic Surgery Department, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar.

Distal thumb injuries are common in high construction load regions, and it is a challenging task for the plastic surgeon to find the optimum choice that preserves thumb length and provides a sensory substitute to the lost tissue. Introducing first dorsal metacarpal artery flap has solved the dilemma. One drawback is that the flap is susceptible to distal necrosis, which can happen because of tight tunneling or insufficient venous drainage. We combined Foucher and Holevich characteristics to design a flap that promises to solve the problem.

Methods: This is a case series that includes 9 patients where we describe a technique that has the potential to enhance the survival of the first dorsal metacarpal artery (FDMA) flap and decreases the rate of distal necrosis via addition of a 5-mm skin bridge to the pedicle and by avoiding tunneling. Distal necrosis of the patients in this study patients was compared with that in a control of 10 patients in whom we did the conventional FDMA flap. Patients were followed for 6 weeks to trace early postoperative complications (infection, dehiscence, and necrosis) and the establishment of protective sensation (pain and temperature).

Results: None of our patients had distal necrosis, infection, or dehiscence, and all had protective sensation in the flap. In comparison, 4 patients in the control group developed distal necrosis.

Conclusion: FDMA is one of the best choices when it comes to distal thumb reconstruction, but it has the disadvantage of distal necrosis, which might be avoided when using the technique mentioned in this study.
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http://dx.doi.org/10.1097/GOX.0000000000003434DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7929644PMC
February 2021

Familial Clustering and Re-infection with 2019 Novel Coronavirus (2019-nCoV, SARS-CoV-2) in the Libyan Community.

Disaster Med Public Health Prep 2021 Mar 8:1-10. Epub 2021 Mar 8.

Department of Microbiology & Parasitology, Faculty of Veterinary Medicine, University of Tripoli, CC82668, Libya.

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http://dx.doi.org/10.1017/dmp.2021.68DOI Listing
March 2021

Modeling microbe-host interaction in the pathogenesis of Crohn's disease.

Int J Med Microbiol 2021 Apr 25;311(3):151489. Epub 2021 Feb 25.

Technical University of Munich, Chair of Nutrition and Immunology, School of Life Sciences, 85354 Freising, Germany; Technical University of Munich, ZIEL Institute for Food & Health, Germany. Electronic address:

Alterations in the gut microbiota structure and function are thought to play an important role in the pathogenesis of Crohn's disease (CD). The rapid advancement of high-throughput sequencing technologies led to the identification of microbiome risk signatures associated with distinct disease phenotypes and progressing disease entities. Functional validation of the identified microbiome signatures is essential to understand the underlying mechanisms of microbe-host interactions. Germfree mouse models are available to study the functional role of disease-conditioning complex gut microbial ecosystems (dysbiosis) or pathobionts (single bacteria) in the pathogenesis of CD-like inflammation. Here, we discuss the clinical and mechanistic relevance and limitations of gnotobiotic mouse models in the context of CD. In addition, we will address the role of diet as an essential external factor modulating microbiome changes, potentially underlying disease initiation and development.
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http://dx.doi.org/10.1016/j.ijmm.2021.151489DOI Listing
April 2021

Candidate Glycoprotein Biomarkers for Canine Visceral Hemangiosarcoma and Validation Using Semi-Quantitative Lectin/Immunohistochemical Assays.

Vet Sci 2021 Feb 27;8(3). Epub 2021 Feb 27.

School of Veterinary Science, The University of Queensland, Gatton, QLD 4343, Australia.

Visceral hemangiosarcoma (HSA) is one of the more frequent cancers in dogs and has a high metastatic rate and poor prognosis, as clinical signs only become apparent in advanced stages of tumor development. In order to improve early and differential diagnostic capabilities and hence, prognosis for dogs with HSA, two types of biomarker are needed: a point-of-care diagnostic biomarker and a prognostic biomarker-preferentially based on samples obtained with minimally invasive methods. In this study, we applied a lectin magnetic bead array-coupled tandem mass spectrometry (LeMBA-MS/MS) workflow through discovery and validation phases to discover serum glycoprotein biomarker candidates for canine HSA. By this approach, we found that (DSA), wheat germ agglutinin (WGA), (SNA), and (PSA) lectins captured the highest number of validated candidate glycoproteins. Secondly, we independently validated serum LeMBA-MS/MS results by demonstrating the in situ relationship of lectin-binding with tumor cells. Using lectin-histochemistry and immunohistochemistry (IHC) for key proteins on tissues with HSA and semi-quantitation of the signals, we demonstrate that a combination of DSA histochemistry and IHC for complement C7 greatly increases the prospect of a more specific diagnosis of canine HSA.
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http://dx.doi.org/10.3390/vetsci8030038DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7997418PMC
February 2021

The Net Clinical Benefit of Rivaroxaban Compared to Low-Molecular-Weight Heparin in the Treatment of Cancer-Associated Thrombosis: Systematic Review and Meta-Analysis.

Clin Appl Thromb Hemost 2021 Jan-Dec;27:1076029620940046

Internal Medicine Department, Hamad General Hospital, 36977Hamad Medical Corporation, Doha, Qatar.

Cancer-associated thrombosis (CAT) carries significant morbidity and mortality. Low-molecular-weight heparin (LMWH) remains the standard of care, with recent systematic studies suggesting the efficacy and safety of rivaroxaban in the treatment of CAT. Uncertainty, however, remains regarding rivaroxaban efficacy and safety in real-world settings. We performed a systematic review and meta-analysis of studies comparing rivaroxaban to LMWH. We searched PubMed, MEDLINE, and EMBASE. The primary outcome was the net clinical benefit (NCB), while rates of major bleeding (MB), venous thromboembolism (VTE), clinically relevant nonmajor bleeding (CRNMB), and all-cause mortality events were secondary outcomes. Seventeen studies were included in the final analysis. Rivaroxaban had a better NCB (relative risk [RR] = 0.82; 95% CI = 0.75-0.89, Q = 10.51, 0%), less VTE events (RR = 0.73, 95% CI = 0.65-0.82, Q = 6.76, = 0%), and lower all-cause mortality (RR = 0.72, 95% CI = 0.57-0.91, Q = 32.8, = 79%) compared to LMWH. Additionally, comparable MB events (RR = 1.07, 95% CI = 0.85-1.33, Q = 16.9, = 11%). However, CRNMB events were higher in the rivaroxaban group (RR = 2.02, 95% CI = 1.46-2.80, Q = 9.9, = 19%). Additional analyses demonstrated consistency of results. Our review encompassing data from randomized and real-world data suggested rivaroxaban superiority compared to LMWH in terms of a better NCB, fewer VTE events, lower all-cause mortality, and comparable MB risk while carrying a higher risk of CRNMB. These findings support the use of rivaroxaban in the treatment of CAT. Additionally, it warrants a sizable randomized controlled study testing the superiority of rivaroxaban versus LMWH formulation and ascertaining bleeding outcomes according to cancer type and site.
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http://dx.doi.org/10.1177/1076029620940046DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7930650PMC
March 2021

Safety of gastrointestinal endoscopy in patients with acute coronary syndrome and concomitant gastrointestinal bleeding.

World J Clin Cases 2021 Feb;9(5):1048-1057

Department of Gastroenterology, Saint Luke's Hospital/University of Missouri Kansas City, Kansas City, MO 64111, United States.

Background: Gastrointestinal bleeding (GIB) is a major concern in patients hospitalized with acute coronary syndrome (ACS) due to the common use of both antiplatelet medications and anticoagulants. Studies evaluating the safety of gastrointestinal endoscopy (GIE) in ACS patients with GIB are limited by their relatively small size, and the focus has generally been on upper GIB and esophago-gastroduod-enoscopy (EGD) only.

Aim: To evaluate the safety profile and the hospitalization outcomes of undergoing GIE in patients with ACS and concomitant GIB using the national database for hospitalized patients in the United States.

Methods: The Nationwide Inpatient Sample database was queried to identify patients hospitalized with ACS and GIB during the same admission between 2005 and 2014. The International Classification of Diseases Code, 9 Revision Clinical Modification was utilized for patient identification. Patients were further classified into two groups based on undergoing endoscopic procedures (EGD, small intestinal endoscopy, colonoscopy, or flexible sigmoidoscopy). Both groups were compared regarding demographic information, outcomes, and comorbi-dities. Multivariate analysis was conducted to identify factors associated with mortality and prolonged length of stay. Chi-square test was used to compare categorical variables, while Student's -test was used to compare continuous variables. All analyses were performed using SAS 9.4 (Cary, NC, United States).

Results: A total of 35612318 patients with ACS were identified between January 2005 and December 2014. 269483 (0.75%) of the patients diagnosed with ACS developed concomitant GIB during the same admission. At least one endoscopic procedure was performed in 68% of the patients admitted with both ACS and GIB. Patients who underwent GIE during the index hospitalization with ACS and GIB had lower mortality (3.8%) compared to the group not undergoing endoscopy (8.6 %, < 0.001). A shorter length of stay (LOS) was observed in patients who underwent GIE (mean 6.59 ± 7.81 d) compared to the group not undergoing endoscopy (mean 7.84 ± 9.73 d, < 0.001). Multivariate analysis showed that performing GIE was associated with lower mortality (odds ratio: 0.58, < 0.001) and shorter LOS (-0.36 factor, < 0.001).

Conclusion: Performing GIE during the index hospitalization of patients with ACS and GIB was correlated with a better mortality rate and a shorter LOS. Approximately two-thirds of patients with both ACS and GIB undergo GIE during the same hospitalization.
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http://dx.doi.org/10.12998/wjcc.v9.i5.1048DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7896652PMC
February 2021

Molecular and functional profiling of apical versus basolateral small extracellular vesicles derived from primary human proximal tubular epithelial cells under inflammatory conditions.

J Extracell Vesicles 2021 Feb 16;10(4):e12064. Epub 2021 Feb 16.

Conjoint Internal Medicine Laboratory, Chemical Pathology Pathology Queensland Brisbane Queensland Australia.

Proximal tubular epithelial cells (PTEC) are central players in inflammatory kidney diseases. However, the complex signalling mechanism/s via which polarized PTEC mediate disease progression are poorly understood. Small extracellular vesicles (sEV), including exosomes, are recognized as fundamental components of cellular communication and signalling courtesy of their molecular cargo (lipids, microRNA, proteins). In this study, we examined the molecular content and function of sEV secreted from the apical versus basolateral surfaces of polarized human primary PTEC under inflammatory diseased conditions. PTEC were cultured under normal and inflammatory conditions on Transwell inserts to enable separate collection and isolation of apical/basolateral sEV. Significantly increased numbers of apical and basolateral sEV were secreted under inflammatory conditions compared with equivalent normal conditions. Multi-omics analysis revealed distinct molecular profiles (lipids, microRNA, proteins) between inflammatory and normal conditions for both apical and basolateral sEV. Biological pathway analyses of significantly differentially expressed molecules associated apical inflammatory sEV with processes of cell survival and immunological disease, while basolateral inflammatory sEV were linked to pathways of immune cell trafficking and cell-to-cell signalling. In line with this mechanistic concept, functional assays demonstrated significantly increased production of chemokines (monocyte chemoattractant protein-1, interleukin-8) and immuno-regulatory cytokine interleukin-10 by peripheral blood mononuclear cells activated with basolateral sEV derived from inflammatory PTEC. We propose that the distinct molecular composition of sEV released from the apical versus basolateral membranes of human inflammatory PTEC may reflect specialized functional roles, with basolateral-derived sEV pivotal in modulating tubulointerstitial inflammatory responses observed in many immune-mediated kidney diseases. These findings provide a rationale to further evaluate these sEV-mediated inflammatory pathways as targets for biomarker and therapeutic development.
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http://dx.doi.org/10.1002/jev2.12064DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7886702PMC
February 2021

Ex vivo glucocorticoid-induced secreted proteome approach for discovery of glucocorticoid-responsive proteins in human serum.

Proteomics Clin Appl 2021 Feb 28:e2000078. Epub 2021 Feb 28.

QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia.

Purpose: To identify glucocorticoid-responsive proteins measurable in human serum that may have clinical utility in therapeutic drug monitoring and the diagnosis of cortisol excess or deficiency.

Experimental Design: A phased biomarker discovery strategy was conducted in two cohorts. Secretome from peripheral blood mononuclear cells (PBMC) isolated from six volunteers after ex vivo incubation ± dexamethasone (DEX) 100 ng/mL for 4 h and 24 h was used for candidate discovery and qualification using untargeted proteomics and a custom multiple reaction monitoring mass spectrometry (MRM-MS) assay, respectively. For validation, five candidates were measured by immunoassay in serum from an independent cohort (n = 20), sampled at 1200 h before and after 4 mg oral DEX.

Results: The discovery secretome proteomics data generated a shortlist of 45 candidates, with 43 measured in the final MRM-MS assay. Differential analysis revealed 16 proteins that were significant in at least one of two time points. In the validation cohort, 3/5 serum proteins were DEX-responsive, two significantly decreased: lysozyme C (p < 0.0001) and nucleophosmin-1 (p < 0.01), while high mobility group box 2 significantly increased (p < 0.01).

Conclusions And Clinical Relevance: Using an ex vivo proteomic approach in PBMC, we have identified circulating glucocorticoid-responsive proteins which may have potential as serum biomarkers of glucocorticoid activity.
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http://dx.doi.org/10.1002/prca.202000078DOI Listing
February 2021

Arrhythmias in Neonates and Infants at a Tertiary Care Center.

Cureus 2021 Jan 22;13(1):e12861. Epub 2021 Jan 22.

Cardiology, American University of Beirut, Beirut, LBN.

Background Limited data about arrhythmias in neonates and infants are coming out from the Middle East. Objectives To evaluate different types of arrhythmias in neonates and infants at the American University of Beirut Medical Center (AUBMC), a tertiary care center in Lebanon, with the focus on the nature of arrhythmia, treatment modalities and relation to surgery. Methods Data were collected retrospectively from the hospital records. We included all neonates and infants presenting to AUBMC between 2013 and 2017. Collected data included: the type of arrhythmia, the treatment modality used and its success, the need for additional modes of treatment, the relationship to congenital heart diseases, and the cardiac surgeries performed. Results Of 16,346 subjects admitted to AUBMC between 2013 and 2017, 90 subjects developed arrhythmias that required medical intervention. The most frequent types of arrhythmias were supraventricular tachycardia (62.22%), junctional ectopic tachycardia (13.33%), complete heart block (7.78%), atrial flutter (5.56%), multifocal atrial tachycardia (3.33%), Wolf Parkinson White Syndrome (3.33%), non-sustained ventricular tachycardia (2.22%), sinus pause (1.11%), and premature ventricular contractions (1.11%). Bivariate analysis showed a significant difference between arrhythmias not related to cardiac surgery and arrhythmias related to cardiac surgery in terms of the type of arrhythmia developed, the presence of congenital heart defect, prematurity, and electrolyte disturbances (P-value <0.005). However, multivariate logistic regression showed no significant difference between the two groups after adjustment for the significant variables (P-value > 0.05). Conclusion There is a significant difference between arrhythmias not related to cardiac surgery and arrhythmias related to cardiac surgery in neonates and infants at AUBMC. However, the difference disappears after adjusting for different variables.
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http://dx.doi.org/10.7759/cureus.12861DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7899244PMC
January 2021

Radium-223 in the Third-Line Setting in Metastatic Castration-Resistant Prostate Cancer: Impact of Concomitant Use of Enzalutamide on Overall Survival (OS) and Predictors of Improved OS.

Clin Genitourin Cancer 2021 Jan 7. Epub 2021 Jan 7.

Division of Nuclear Medicine, Department of Radiology, Mayo Clinic, Rochester, MN.

Introduction: Radium-223 (Ra-223) has been recommended for bone-dominant metastatic castration-resistant prostate cancer (mCRPC). Second-generation hormone therapy in combination with Ra-223 in mCRPC has been utilized, yet its benefit has not been well elucidated. We investigated the potential survival benefit of concomitant enzalutamide with Ra-223 in the third-line setting and predictors of improved overall survival (OS).

Patients And Methods: We retrospectively identified 51 patients with bone-dominant mCRPC that were treated with Ra-223 in the postchemotherapy and post-hormone therapy setting, either alone (group A; n = 32) or with concomitant enzalutamide (group B; n = 19). The primary endpoint was to study the OS difference between groups A and B. The secondary endpoint was to identify predictors of improved OS with Ra-223 in the third-line setting.

Results: Mean age was 70.9 years, median baseline prostatic-specific antigen (PSA) was 23.1 ng/mL, alkaline phosphatase was 91 IU/L, and hemoglobin was 12.5 g/dL. There was no difference in median OS between groups A and B, at 20.4 versus 17.5 months, respectively (P = .5186). In univariate and multivariate analyses, only pre-Ra-223 PSA < 30 ng/mL and Eastern Cooperative Oncology Group performance status < 2 were associated with improved OS.

Conclusion: In our study cohort, concomitant use of enzalutamide with Ra-223 in the mCRPC setting was not associated with improved OS. Only pretreatment PSA < 30 ng/mL and pretreatment Eastern Cooperative Oncology Group performance status < 2 were associated with improved OS. Further prospective studies are warranted.
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http://dx.doi.org/10.1016/j.clgc.2020.12.009DOI Listing
January 2021

Prevalence and antimicrobial resistance of species isolated from cats and dogs.

Open Vet J 2021 Jan 19;10(4):452-456. Epub 2020 Dec 19.

Department of Microbiology and Parasitology, Faculty of Veterinary Medicine, University of Tripoli, Tripoli, Libya.

Background: Methicillin-resistant staphylococci (MRS) are an emerging global problem with serious public health concern.

Aims: This study investigated the prevalence and antimicrobial susceptibility of commensal species isolated from healthy and clinical cats and dogs.

Methods: Nasal swab samples were collected from animals and processed using selective and semi-selective mediums. Presumptive isolates were subjected to biochemical testing and analyzed using the Phoenix automated identification and susceptibility testing system. PCRs protocols were used to screen for and pvl genes.

Results: In total, 151 pets (103 cats and 48 dogs) were enrolled, of which 14 dogs (29%) and 24 cats (23%) were colonized with various Staphylococcus species mainly originated from healthy animals. A total of 38 staphylococci isolates were collected and distributed between 24 coagulase-negative and 14 coagulase-positive staphylococci. Only 13 staphylococci strains were identified as MRS, out of which only five isolates expressed that the gene exclusively originated from healthy pets.

Conclusion: This is the first study reporting the prevalence and colonization status of staphylococci species and MRS strains isolated from cats and dogs in Libya. The study reports important information of medical and clinical importance on antimicrobial and multidrug resistance of different staphylococci strains, particularly the coagulase negative species.
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http://dx.doi.org/10.4314/ovj.v10i4.13DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7830183PMC
January 2021