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Allam AR, Elsayed MA, Daghash IT, Abdelaziz AM, Mostafa OM, Sabra HK, Eldaboush AM, Ahmed NMB, Elweza RT, Adwy ES, Hammad AE, Kabbash IA, Allam AH, Bahbah AA, Ewis MI, Mohamed Shawqi M, Behery MB, Mohamed El-Said Y, Radwan AE, KhallafAllah MT, Aboshady OA, Gouda MA. Colonoscopy screening for colorectal cancer in Egypt: a nationwide cross-sectional study. BMC Cancer 2024; 24:131. [PMID: 38273265 PMCID: PMC10809530 DOI: 10.1186/s12885-024-11828-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Accepted: 01/03/2024] [Indexed: 01/27/2024] Open
Abstract
BACKGROUND Current guidelines advocate for colorectal cancer (CRC) screening in adults who are at risk by using direct visualization methods such as colonoscopy. However, in Egypt, there is a paucity of data regarding the current practice of colonoscopy screening. Moreover, more information is needed about the knowledge and attitudes of potential participants regarding the procedure and possible barriers that can limit their participation. METHODS We conducted a nationwide cross-sectional study using an interview-based survey of patients aged 45 years or above who presented to outpatient clinics of nine university hospitals throughout Egypt. Participants were surveyed to assess their compliance with CRC colonoscopy screening guidelines, their knowledge of and attitude towards colonoscopy screening, and their perspective on potential barriers to colonoscopy screening. RESULTS A total of 1,453 participants responded to our survey in the nine study centers. Only a minority of participants (2.3%) were referred for CRC screening. Referral rates were higher among those who knew someone with a history of CRC (5.3% vs 1.5%, p < 0.001) or had a discussion with their physician about CRC (25.8% vs 0.7%, p < 0.001). Few responders (3.2%) had good knowledge regarding CRC screening. After introducing the concept of CRC screening to all participants, most patients (66.7%) showed a positive attitude towards having the procedure. Financial burden and fear of results were the two most frequently cited barriers to undergoing CRC screening (81.1%; and 60.1%, respecteively). CONCLUSIONS Despite the positive attitude, there is insufficient knowledge about CRC screening among eligible participants in Egypt. This has probably contributed to low compliance with current CRC screening guidelines and needs to be addressed at the national level.
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Affiliation(s)
| | | | | | - Ali M Abdelaziz
- Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Omar Ali Aboshady
- Faculty of Medicine, Menoufia University, Menoufia, Egypt
- College of Pharmacy, Purdue University, West Lafayette, IN, USA
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Allam AH, Eltewacy NK, Alabdallat YJ, Owais TA, Salman S, Ebada MA. Knowledge, attitude, and perception of Arab medical students towards artificial intelligence in medicine and radiology: A multi-national cross-sectional study. Eur Radiol 2023:10.1007/s00330-023-10509-2. [PMID: 38150076 DOI: 10.1007/s00330-023-10509-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Revised: 09/26/2023] [Accepted: 11/02/2023] [Indexed: 12/28/2023]
Abstract
OBJECTIVES We aimed to assess undergraduate medical students' knowledge, attitude, and perception regarding artificial intelligence (AI) in medicine. METHODS A multi-national, multi-center cross-sectional study was conducted from March to April 2022, targeting undergraduate medical students in nine Arab countries. The study utilized a web-based questionnaire, with data collection carried out with the help of national leaders and local collaborators. Logistic regression analysis was performed to identify predictors of knowledge, attitude, and perception among the participants. Additionally, cluster analysis was employed to identify shared patterns within their responses. RESULTS Of the 4492 students surveyed, 92.4% had not received formal AI training. Regarding AI and deep learning (DL), 87.1% exhibited a low level of knowledge. Most students (84.9%) believed AI would revolutionize medicine and radiology, with 48.9% agreeing that it could reduce the need for radiologists. Students with high/moderate AI knowledge and training had higher odds of agreeing to endorse AI replacing radiologists, reducing their numbers, and being less likely to consider radiology as a career compared to those with low knowledge/no AI training. Additionally, the majority agreed that AI would aid in the automated detection and diagnosis of pathologies. CONCLUSIONS Arab medical students exhibit a notable deficit in their knowledge and training pertaining to AI. Despite this, they hold a positive perception of AI implementation in medicine and radiology, demonstrating a clear understanding of its significance for the healthcare system and medical curriculum. CLINICAL RELEVANCE STATEMENT This study highlights the need for widespread education and training in artificial intelligence for Arab medical students, indicating its significance for healthcare systems and medical curricula. KEY POINTS • Arab medical students demonstrate a significant knowledge and training gap when it comes to using AI in the fields of medicine and radiology. • Arab medical students recognize the importance of integrating AI into the medical curriculum. Students with a deeper understanding of AI were more likely to agree that all medical students should receive AI education. However, those with previous AI training were less supportive of this idea. • Students with moderate/high AI knowledge and training displayed increased odds of agreeing that AI has the potential to replace radiologists, reduce the demand for their services, and were less inclined to pursue a career in radiology, when compared to students with low knowledge/no AI training.
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Affiliation(s)
- Ahmed Hafez Allam
- Faculty of Medicine, Menoufia University, Shebin El-Kom, Menoufia, Egypt.
- Eltewacy Arab Research Group, Cairo, Egypt.
| | - Nael Kamel Eltewacy
- Eltewacy Arab Research Group, Cairo, Egypt
- Faculty of Pharmacy, Beni-Suef University, Beni-Suef, Egypt
| | - Yasmeen Jamal Alabdallat
- Eltewacy Arab Research Group, Cairo, Egypt
- Faculty of Medicine, Hashemite University, Zarqa, Jordan
| | - Tarek A Owais
- Eltewacy Arab Research Group, Cairo, Egypt
- Faculty of Pharmacy, Beni-Suef University, Beni-Suef, Egypt
| | - Saif Salman
- Eltewacy Arab Research Group, Cairo, Egypt
- Mayo Clinic College of Medicine, Jacksonville, FL, USA
| | - Mahmoud A Ebada
- Eltewacy Arab Research Group, Cairo, Egypt
- Faculty of Medicine, Zagazig University, Zagazig, El-Sharkia, Egypt
- Egyptian Fellowship of Neurology, Nasr City Hospital for Health Insurance, Nasr City, Cairo, Egypt
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Taha AM, Shaarawy AS, Omar MM, Abouelmagd K, Shalma NM, Alhashemi M, Ahmed HM, Allam AH, Abd-ElGawad M. Effect of Omega-3 fatty acids supplementation on serum level of C-reactive protein in patients with COVID-19: a systematic review and meta-analysis of randomized controlled trials. J Transl Med 2022; 20:401. [PMID: 36064554 PMCID: PMC9444081 DOI: 10.1186/s12967-022-03604-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Accepted: 08/19/2022] [Indexed: 01/08/2023] Open
Abstract
Background Omega-3 may alleviate the severity of coronavirus disease 2019 (COVID-19) by reducing the C-reactive protein (CRP) level, a marker for systemic inflammation. Because the scientific evidence indicating such a role is inconsistent, we aimed to evaluate the effect of Omega-3 on CRP change and CRP level in patients with COVID-19. Methods We conducted a comprehensive search on four databases (PubMed, Web of Science, EMBASE, and Scopus). We included all RCTs comparing Omega-3 with a control group regarding their effect on the CRP levels in patients with COVID-19. We used version two of the Cochrane risk of bias assessment tool to appraise the included studies. We extracted data to an online data extraction sheet. The primary outcomes were CRP change from baseline and CRP serum levels. Results We included four randomized controlled trials (RCTs) with 274 patients in this study. The overall effect estimate favored Omega-3 over the control group in terms of CRP change from baseline (mean difference (MD) =− 2.53, 95% confidence interval (CI): − 4.40, − 0.66) and CRP serum levels at the end of the study (MD =− 6.24, 95% CI: − 11.93, − 0.54). Conclusion Omega-3 showed promising effects on systemic inflammation by reducing CRP levels in COVID-19 patients. Based on this finding, we recommend Omega-3 for COVID-19 patients for its anti-inflammatory actions. Supplementary Information The online version contains supplementary material available at 10.1186/s12967-022-03604-3.
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Affiliation(s)
- Amira Mohamed Taha
- Faculty of Medicine, Fayoum University, Postal address; Bank street, Talat, Fayoum, 63622, Egypt.
| | | | | | | | | | - Mais Alhashemi
- Faculty of Medicine, University of Aleppo, Aleppo, Syria
| | | | - Ahmed Hafez Allam
- Faculty of Medicine, Menoufia University, Shebin El-Kom, Menoufia, Egypt
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4
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Thompson R, Trumble BC, Bajwa EI, Cummings DK, Rowan CJ, Narula J, Allam AH, Wann LS, Gurven M, Stieglitz M, Thomspon EC, Neunuebel FM, Walsworth K, Kaplan H, Thomas GS. 35Frequent Aortic Valve Calcium in a Population with Minimal Atherosclerosis. Eur Heart J Cardiovasc Imaging 2019. [DOI: 10.1093/ehjci/jez135.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- R Thompson
- Mid America Heart Institute, Kansas City, United States of America
| | - B C Trumble
- Mid America Heart Institute, Kansas City, United States of America
| | - E I Bajwa
- University of California, Irvine, United States of America
| | - D K Cummings
- Mid America Heart Institute, Kansas City, United States of America
| | - C J Rowan
- Mid America Heart Institute, Kansas City, United States of America
| | - J Narula
- Mount Sinai Medical Center, New York, United States of America
| | | | - L S Wann
- Mid America Heart Institute, Kansas City, United States of America
| | - M Gurven
- University of California, San Diego, San Diego, United States of America
| | - M Stieglitz
- Mid America Heart Institute, Kansas City, United States of America
| | - E C Thomspon
- Mid America Heart Institute, Kansas City, United States of America
| | - F M Neunuebel
- Mid America Heart Institute, Kansas City, United States of America
| | - K Walsworth
- Mid America Heart Institute, Kansas City, United States of America
| | - H Kaplan
- Mid America Heart Institute, Kansas City, United States of America
| | - G S Thomas
- University of California, Irvine, United States of America
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5
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Benthani FA, Herrmann D, Tran PN, Pangon L, Lucas MC, Allam AH, Currey N, Al-Sohaily S, Giry-Laterriere M, Warusavitarne J, Timpson P, Kohonen-Corish MRJ. 'MCC' protein interacts with E-cadherin and β-catenin strengthening cell-cell adhesion of HCT116 colon cancer cells. Oncogene 2017; 37:663-672. [PMID: 29035389 DOI: 10.1038/onc.2017.362] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2016] [Revised: 08/14/2017] [Accepted: 08/25/2017] [Indexed: 02/06/2023]
Abstract
E-cadherin and β-catenin are key proteins that are essential in the formation of the epithelial cell layer in the colon but their regulatory pathways that are disrupted in cancer metastasis are not completely understood. Mutated in colorectal cancer (MCC) is a tumour suppressor gene that is silenced by promoter methylation in colorectal cancer and particularly in patients with increased lymph node metastasis. Here, we show that MCC methylation is found in 45% of colon and 24% of rectal cancers and is associated with proximal colon, poorly differentiated, circumferential and mucinous tumours as well as increasing T stage and larger tumour size. Knockdown of MCC in HCT116 colon cancer cells caused a reduction in E-cadherin protein level, which is a hallmark of epithelial-mesenchymal transition in cancer, and consequently diminished the E-cadherin/β-catenin complex. MCC knockdown disrupted cell-cell adhesive strength and integrity in the dispase and transepithelial electrical resistance assays, enhanced hepatocyte growth factor-induced cell scatter and increased tumour cell invasiveness in an organotypic assay. The Src/Abl inhibitor dasatinib, a candidate anti-invasive drug, abrogated the invasive properties induced by MCC deficiency. Mechanistically, we establish that MCC interacts with the E-cadherin/β-catenin complex. These data provide a significant advance in the current understanding of cell-cell adhesion in colon cancer cells.
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Affiliation(s)
- F A Benthani
- The Kinghorn Cancer Centre, Garvan Institute of Medical Research, Darlinghurst, New South Wales, Australia.,St Vincent's Clinical School, UNSW Sydney, Sydney, New South Wales, Australia
| | - D Herrmann
- The Kinghorn Cancer Centre, Garvan Institute of Medical Research, Darlinghurst, New South Wales, Australia.,St Vincent's Clinical School, UNSW Sydney, Sydney, New South Wales, Australia
| | - P N Tran
- The Kinghorn Cancer Centre, Garvan Institute of Medical Research, Darlinghurst, New South Wales, Australia.,St Vincent's Clinical School, UNSW Sydney, Sydney, New South Wales, Australia
| | - L Pangon
- The Kinghorn Cancer Centre, Garvan Institute of Medical Research, Darlinghurst, New South Wales, Australia.,St Vincent's Clinical School, UNSW Sydney, Sydney, New South Wales, Australia
| | - M C Lucas
- The Kinghorn Cancer Centre, Garvan Institute of Medical Research, Darlinghurst, New South Wales, Australia
| | - A H Allam
- The Kinghorn Cancer Centre, Garvan Institute of Medical Research, Darlinghurst, New South Wales, Australia
| | - N Currey
- The Kinghorn Cancer Centre, Garvan Institute of Medical Research, Darlinghurst, New South Wales, Australia
| | - S Al-Sohaily
- The Kinghorn Cancer Centre, Garvan Institute of Medical Research, Darlinghurst, New South Wales, Australia
| | - M Giry-Laterriere
- The Kinghorn Cancer Centre, Garvan Institute of Medical Research, Darlinghurst, New South Wales, Australia
| | - J Warusavitarne
- The Kinghorn Cancer Centre, Garvan Institute of Medical Research, Darlinghurst, New South Wales, Australia
| | - P Timpson
- The Kinghorn Cancer Centre, Garvan Institute of Medical Research, Darlinghurst, New South Wales, Australia.,St Vincent's Clinical School, UNSW Sydney, Sydney, New South Wales, Australia
| | - M R J Kohonen-Corish
- The Kinghorn Cancer Centre, Garvan Institute of Medical Research, Darlinghurst, New South Wales, Australia.,St Vincent's Clinical School, UNSW Sydney, Sydney, New South Wales, Australia.,School of Medicine, Western Sydney University, Sydney, New South Wales, Australia
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6
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Harris NLE, Vennin C, Conway JRW, Vine KL, Pinese M, Cowley MJ, Shearer RF, Lucas MC, Herrmann D, Allam AH, Pajic M, Morton JP, Biankin AV, Ranson M, Timpson P, Saunders DN. SerpinB2 regulates stromal remodelling and local invasion in pancreatic cancer. Oncogene 2017; 36:4288-4298. [PMID: 28346421 PMCID: PMC5537606 DOI: 10.1038/onc.2017.63] [Citation(s) in RCA: 71] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2016] [Revised: 01/11/2017] [Accepted: 02/08/2017] [Indexed: 02/07/2023]
Abstract
Pancreatic cancer has a devastating prognosis, with an overall 5-year survival rate of ~8%, restricted treatment options and characteristic molecular heterogeneity. SerpinB2 expression, particularly in the stromal compartment, is associated with reduced metastasis and prolonged survival in pancreatic ductal adenocarcinoma (PDAC) and our genomic analysis revealed that SERPINB2 is frequently deleted in PDAC. We show that SerpinB2 is required by stromal cells for normal collagen remodelling in vitro, regulating fibroblast interaction and engagement with collagen in the contracting matrix. In a pancreatic cancer allograft model, co-injection of PDAC cancer cells and SerpinB2-/- mouse embryonic fibroblasts (MEFs) resulted in increased tumour growth, aberrant remodelling of the extracellular matrix (ECM) and increased local invasion from the primary tumour. These tumours also displayed elevated proteolytic activity of the primary biochemical target of SerpinB2-urokinase plasminogen activator (uPA). In a large cohort of patients with resected PDAC, we show that increasing uPA mRNA expression was significantly associated with poorer survival following pancreatectomy. This study establishes a novel role for SerpinB2 in the stromal compartment in PDAC invasion through regulation of stromal remodelling and highlights the SerpinB2/uPA axis for further investigation as a potential therapeutic target in pancreatic cancer.
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Affiliation(s)
- N L E Harris
- Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, Australia
- Centre for Medical and Molecular Bioscience, University of Wollongong, Wollongong, Australia
- School of Biological Sciences, University of Wollongong, Wollongong, Australia
| | - C Vennin
- Kinghorn Cancer Center, Garvan Institute of Medical Research, Darlinghurst, Australia
- St Vincent’s Clinical School, Faculty of Medicine, University of New South Wales, Darlinghurst, Australia
| | - J R W Conway
- Kinghorn Cancer Center, Garvan Institute of Medical Research, Darlinghurst, Australia
- St Vincent’s Clinical School, Faculty of Medicine, University of New South Wales, Darlinghurst, Australia
| | - K L Vine
- Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, Australia
- Centre for Medical and Molecular Bioscience, University of Wollongong, Wollongong, Australia
- School of Biological Sciences, University of Wollongong, Wollongong, Australia
| | - M Pinese
- Kinghorn Cancer Center, Garvan Institute of Medical Research, Darlinghurst, Australia
| | - M J Cowley
- Kinghorn Cancer Center, Garvan Institute of Medical Research, Darlinghurst, Australia
| | - R F Shearer
- Kinghorn Cancer Center, Garvan Institute of Medical Research, Darlinghurst, Australia
- St Vincent’s Clinical School, Faculty of Medicine, University of New South Wales, Darlinghurst, Australia
| | - M C Lucas
- Kinghorn Cancer Center, Garvan Institute of Medical Research, Darlinghurst, Australia
- St Vincent’s Clinical School, Faculty of Medicine, University of New South Wales, Darlinghurst, Australia
| | - D Herrmann
- Kinghorn Cancer Center, Garvan Institute of Medical Research, Darlinghurst, Australia
- St Vincent’s Clinical School, Faculty of Medicine, University of New South Wales, Darlinghurst, Australia
| | - A H Allam
- Kinghorn Cancer Center, Garvan Institute of Medical Research, Darlinghurst, Australia
| | - M Pajic
- Kinghorn Cancer Center, Garvan Institute of Medical Research, Darlinghurst, Australia
- St Vincent’s Clinical School, Faculty of Medicine, University of New South Wales, Darlinghurst, Australia
| | - J P Morton
- Cancer Research UK Beatson Institute, Glasgow, Scotland
| | - Australian Pancreatic Cancer Genome Initiative
- Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, Australia
- Centre for Medical and Molecular Bioscience, University of Wollongong, Wollongong, Australia
- School of Biological Sciences, University of Wollongong, Wollongong, Australia
- Kinghorn Cancer Center, Garvan Institute of Medical Research, Darlinghurst, Australia
- St Vincent’s Clinical School, Faculty of Medicine, University of New South Wales, Darlinghurst, Australia
- Cancer Research UK Beatson Institute, Glasgow, Scotland
- Wolfson Wohl Cancer Research Centre, Institute of Cancer Sciences, University of Glasgow, Glasgow, UK
- School of Medical Sciences, University of New South Wales, Sydney, Australia
| | - A V Biankin
- Wolfson Wohl Cancer Research Centre, Institute of Cancer Sciences, University of Glasgow, Glasgow, UK
| | - M Ranson
- Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, Australia
- Centre for Medical and Molecular Bioscience, University of Wollongong, Wollongong, Australia
- School of Biological Sciences, University of Wollongong, Wollongong, Australia
| | - P Timpson
- Kinghorn Cancer Center, Garvan Institute of Medical Research, Darlinghurst, Australia
- St Vincent’s Clinical School, Faculty of Medicine, University of New South Wales, Darlinghurst, Australia
| | - D N Saunders
- Kinghorn Cancer Center, Garvan Institute of Medical Research, Darlinghurst, Australia
- School of Medical Sciences, University of New South Wales, Sydney, Australia
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7
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Butala NM, Desai MM, Linnander EL, Wong YR, Mikhail DG, Ott LS, Spertus JA, Bradley EH, Aaty AA, Abdelfattah A, Gamal A, Kholeif H, el-Baz M, Allam AH, Krumholz HM. Gender differences in presentation, management, and in-hospital outcomes for patients with AMI in a lower-middle income country: evidence from Egypt. PLoS One 2011; 6:e25904. [PMID: 22022463 PMCID: PMC3192760 DOI: 10.1371/journal.pone.0025904] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2011] [Accepted: 09/13/2011] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Many studies in high-income countries have investigated gender differences in the care and outcomes of patients hospitalized with acute myocardial infarction (AMI). However, little evidence exists on gender differences among patients with AMI in lower-middle-income countries, where the proportion deaths stemming from cardiovascular disease is projected to increase dramatically. This study examines gender differences in patients in the lower-middle-income country of Egypt to determine if female patients with AMI have a different presentation, management, or outcome compared with men. METHODS AND FINDINGS Using registry data collected over 18 months from 5 Egyptian hospitals, we considered 1204 patients (253 females, 951 males) with a confirmed diagnosis of AMI. We examined gender differences in initial presentation, clinical management, and in-hospital outcomes using t-tests and χ(2) tests. Additionally, we explored gender differences in in-hospital death using multivariate logistic regression to adjust for age and other differences in initial presentation. We found that women were older than men, had higher BMI, and were more likely to have hypertension, diabetes mellitus, dyslipidemia, heart failure, and atrial fibrillation. Women were less likely to receive aspirin upon admission (p<0.01) or aspirin or statins at discharge (p = 0.001 and p<0.05, respectively), although the magnitude of these differences was small. While unadjusted in-hospital mortality was significantly higher for women (OR: 2.10; 95% CI: 1.54 to 2.87), this difference did not persist in the fully adjusted model (OR: 1.18; 95% CI: 0.55 to 2.55). CONCLUSIONS We found that female patients had a different profile than men at the time of presentation. Clinical management of men and women with AMI was similar, though there are small but significant differences in some areas. These gender differences did not translate into differences in in-hospital outcome, but highlight differences in quality of care and represent important opportunities for improvement.
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Affiliation(s)
- Neel M Butala
- Yale School of Medicine, New Haven, Connecticut, United States of America.
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