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O'Reilly K, McDonnell JM, Ibrahim S, Butler JS, Martin-Smith JD, O'Sullivan JB, Dolan RT. Biomechanical and ergonomic risks associated with cervical musculoskeletal dysfunction amongst surgeons: A systematic review. Surgeon 2024:S1479-666X(24)00035-0. [PMID: 38693029 DOI: 10.1016/j.surge.2024.04.003] [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: 12/13/2023] [Revised: 04/02/2024] [Accepted: 04/03/2024] [Indexed: 05/03/2024]
Abstract
INTRODUCTION Surgeons are at high risk of developing musculoskeletal symptoms due to a range of factors including, maladaptive positioning and surgical ergonomics. Cervical muscle strain and biomechanical load is most prevalent due to repetitive motions and prolonged static neck positioning. This issue is apparent through reports of prevalence between 10 and 74.4% among surgeons. The aim of this systematic review is to provide an objective assessment of the clinical evidence available and a descriptive analysis of the effects of kinematics and surgical ergonomics on the prevalence of surgeons' cervical musculoskeletal pain. METHODS This is PRISMA-compliant systematic review of clinical studies assessing the prevalence of cervical musculoskeletal dysfunction in surgeons by searching PUBMED and Ovid EMBASE databases from inception to 19th October 2023. Study quality was graded according to the National Institutes of Health study quality assessment tools. RESULTS A total of 9 studies were included in the final qualitative analysis. The use of loupes, open surgery and excessive neck flexion (>30°) were associated with cervical dysfunction. Comparison of study outcomes was challenging due to heterogeneity within study methods and the paucity of methodological quality. CONCLUSION The current literature assessing ergonomic and biomechanical factors predisposing surgeons to cervical musculoskeletal dysfunction is insufficient to provide reliable guidance for clinicians. Although the literature identifies factors contributing to work-related cervical dysfunction, few attempt to evaluate interventions for improved surgical ergonomics. An objective assessment of interventions that prompt postural correction with the aim to improve neck pain in surgeon cohorts is warranted.
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Affiliation(s)
- K O'Reilly
- Department of Plastic & Reconstructive Surgery, Beaumont Hospital, Dublin, Ireland; Department of Surgery, Royal College of Surgeons in Ireland, Ireland.
| | - J M McDonnell
- National Spinal Injuries Unit, Mater Misericordiae University Hospital, Dublin 7, Ireland; UCD School of Medicine & Medical Science, University College Dublin, Ireland
| | - S Ibrahim
- Department of Plastic & Reconstructive Surgery, Beaumont Hospital, Dublin, Ireland; Department of Surgery, Royal College of Surgeons in Ireland, Ireland
| | - J S Butler
- National Spinal Injuries Unit, Mater Misericordiae University Hospital, Dublin 7, Ireland; UCD School of Medicine & Medical Science, University College Dublin, Ireland
| | - J D Martin-Smith
- Department of Plastic & Reconstructive Surgery, Beaumont Hospital, Dublin, Ireland; Department of Surgery, Royal College of Surgeons in Ireland, Ireland
| | - J B O'Sullivan
- Department of Plastic & Reconstructive Surgery, Beaumont Hospital, Dublin, Ireland; Department of Surgery, Royal College of Surgeons in Ireland, Ireland
| | - R T Dolan
- Department of Plastic & Reconstructive Surgery, Beaumont Hospital, Dublin, Ireland; Department of Surgery, Royal College of Surgeons in Ireland, Ireland
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Ibrahim S, Ali AA, Fathi AM. A comprehensive investigation of Bi 2O 3 on the physical, structural, optical, and electrical properties of K 2O.ZnO.V 2O 5.B 2O 3 glasses. Sci Rep 2024; 14:8518. [PMID: 38609403 DOI: 10.1038/s41598-024-58567-w] [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: 11/30/2023] [Accepted: 04/01/2024] [Indexed: 04/14/2024] Open
Abstract
The multi-component glass system has a composition of 10K2O-10ZnO-55 B2O3-(25-x)V2O5-xBi2O3 (x = 4, 5, 7.5, 9, 10 mol%) are synthesized by the melt-quenching method. Using X-ray diffraction examination, the amorphous phase in the material was confirmed. The physical characteristics of the produced compositions are examined using density (D) and molar volume (Vm). Calculations of physical properties showed that adding Bi2O3 from 4 to 10 mol% increased the glass density from 2.7878 to 3.3617 g cm-3 and decreased the molar volume from 40.4196 to 38.5895 cm3/mol. Studies of glass samples using the FTIR show bands of absorption for oxides in different structural groups. Octahedral [ BiO 6 ], [ BO 4 ], and tetrahedral [ BO 3 ] structural units are observed in the present glass matrices. The cutoff wavelength ( λ C ), and optical band gap energy were determined using UV absorption spectra. The increase in non-bridging oxygens can be linked to the decrease in optical band gap energy ( E opt ) (direct and indirect) and the increase in cutoff wavelength with an increase in Bi2O3 content. This is attributed to the existence of bismuth ions and the creation of non-bridging oxygens. Besides that, the values of optical parameters, viz., optical electronegativity, refractive index, and molar refractivity, are calculated. The metallization criterion values are less than 1 and the glass samples exhibit an increased tendency towards metallization. Both the conductivity and the dielectric constant increase with the rise in Bi2O3 content, however, the dielectric loss and the impedance reduce. The behavior and values of conductivity for the studied glasses reveal the semiconducting properties of all glass samples. These results suggest that the produced glass samples may be employed as amorphous semiconductors in electronics and memory switching devices.
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Affiliation(s)
- S Ibrahim
- Glass Research Department, National Research Centre, El-Buhouth St., Dokki, Giza, 12622, Egypt.
| | - A A Ali
- Glass Research Department, National Research Centre, El-Buhouth St., Dokki, Giza, 12622, Egypt
| | - Ahlam M Fathi
- Physical Chemistry Department, National Research Centre, El-Buhouth St., Dokki, Giza, 12622, Egypt
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Ng YH, Chai YC, Mazli N, Jaafar NF, Ibrahim S. Outcome of Endoprosthesis used in Limb Salvage Surgery in a Malaysian Orthopaedic Oncology Centre. Malays Orthop J 2024; 18:60-65. [PMID: 38638655 PMCID: PMC11023336 DOI: 10.5704/moj.2403.008] [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: 06/02/2023] [Accepted: 08/14/2023] [Indexed: 04/20/2024] Open
Abstract
Introduction To describe the duration of survival among bone tumour patients with endoprosthesis reconstruction and to determine frequency of implant failure, revision of surgery, and amputation after endoprosthesis reconstruction. Materials and methods A retrospective cross-sectional review of all patients with either primary bone tumour or secondary bone metastases treated with en bloc resection and endoprosthesis reconstruction from January 2008 to December 2020. Results A total of 35 failures were recorded among the 27 (48.2%) patients with endoprostheses. Some of the patients suffered from one to three types of modes of failure on different timelines during the course of the disease. Up to eight patients suffered from more than one type of failure throughout the course of the disease. Out of all modes of failure, local recurrence (type 5 failure) was the most common, accounting for 25.0% of all failure cases. Four patients (7.1%) eventually underwent amputation, which were either due to infection (2 patients) or disease progression causing local recurrence (2 patients). Conclusion The overall result of endoprosthesis reconstruction performed in our centre was compatible with other centres around the world. Moreover, limb salvage surgery should be performed carefully in a selected patient group to maximise the benefits of surgery.
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Affiliation(s)
- Y H Ng
- Department of Orthopaedic, Hospital Sultan Ismail, Johor Bahru, Malaysia
| | - Y C Chai
- General Psychiatry Division, Hospital Permai Johor Bahru, Johor Bahru, Malaysia
| | - N Mazli
- Department of Orthopaedics and Traumatology, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - N F Jaafar
- Department of Orthopaedic, Hospital Sultan Ismail, Johor Bahru, Malaysia
| | - S Ibrahim
- Department of Orthopaedic, Hospital Sultan Ismail, Johor Bahru, Malaysia
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Staplin N, Haynes R, Judge PK, Wanner C, Green JB, Emberson J, Preiss D, Mayne KJ, Ng SYA, Sammons E, Zhu D, Hill M, Stevens W, Wallendszus K, Brenner S, Cheung AK, Liu ZH, Li J, Hooi LS, Liu WJ, Kadowaki T, Nangaku M, Levin A, Cherney D, Maggioni AP, Pontremoli R, Deo R, Goto S, Rossello X, Tuttle KR, Steubl D, Petrini M, Seidi S, Landray MJ, Baigent C, Herrington WG, Abat S, Abd Rahman R, Abdul Cader R, Abdul Hafidz MI, Abdul Wahab MZ, Abdullah NK, Abdul-Samad T, Abe M, Abraham N, Acheampong S, Achiri P, Acosta JA, Adeleke A, Adell V, Adewuyi-Dalton R, Adnan N, Africano A, Agharazii M, Aguilar F, Aguilera A, Ahmad M, Ahmad MK, Ahmad NA, Ahmad NH, Ahmad NI, Ahmad Miswan N, Ahmad Rosdi H, Ahmed I, Ahmed S, Ahmed S, Aiello J, Aitken A, AitSadi R, Aker S, Akimoto S, Akinfolarin A, Akram S, Alberici F, Albert C, Aldrich L, Alegata M, Alexander L, Alfaress S, Alhadj Ali M, Ali A, Ali A, Alicic R, Aliu A, Almaraz R, Almasarwah R, Almeida J, Aloisi A, Al-Rabadi L, Alscher D, Alvarez P, Al-Zeer B, Amat M, Ambrose C, Ammar H, An Y, Andriaccio L, Ansu K, Apostolidi A, Arai N, Araki H, Araki S, Arbi A, Arechiga O, Armstrong S, Arnold T, Aronoff S, Arriaga W, Arroyo J, Arteaga D, Asahara S, Asai A, Asai N, Asano S, Asawa M, Asmee MF, Aucella F, Augustin M, Avery A, Awad A, Awang IY, Awazawa M, Axler A, Ayub W, Azhari Z, Baccaro R, Badin C, Bagwell B, Bahlmann-Kroll E, Bahtar AZ, Baigent C, Bains D, Bajaj H, Baker R, Baldini E, Banas B, Banerjee D, Banno S, Bansal S, Barberi S, Barnes S, Barnini C, Barot C, Barrett K, Barrios R, Bartolomei Mecatti B, Barton I, Barton J, Basily W, Bavanandan S, Baxter A, Becker L, Beddhu S, Beige J, Beigh S, Bell S, Benck U, Beneat A, Bennett A, Bennett D, Benyon S, Berdeprado J, Bergler T, Bergner A, Berry M, Bevilacqua M, Bhairoo J, Bhandari S, Bhandary N, Bhatt A, Bhattarai M, Bhavsar M, Bian W, Bianchini F, Bianco S, Bilous R, Bilton J, Bilucaglia D, Bird C, Birudaraju D, Biscoveanu M, Blake C, Bleakley N, Bocchicchia K, Bodine S, Bodington R, Boedecker S, Bolduc M, Bolton S, Bond C, Boreky F, Boren K, Bouchi R, Bough L, Bovan D, Bowler C, Bowman L, Brar N, Braun C, Breach A, Breitenfeldt M, Brenner S, Brettschneider B, Brewer A, Brewer G, Brindle V, Brioni E, Brown C, Brown H, Brown L, Brown R, Brown S, Browne D, Bruce K, Brueckmann M, Brunskill N, Bryant M, Brzoska M, Bu Y, Buckman C, Budoff M, Bullen M, Burke A, Burnette S, Burston C, Busch M, Bushnell J, Butler S, Büttner C, Byrne C, Caamano A, Cadorna J, Cafiero C, Cagle M, Cai J, Calabrese K, Calvi C, Camilleri B, Camp S, Campbell D, Campbell R, Cao H, Capelli I, Caple M, Caplin B, Cardone A, Carle J, Carnall V, Caroppo M, Carr S, Carraro G, Carson M, Casares P, Castillo C, Castro C, Caudill B, Cejka V, Ceseri M, Cham L, Chamberlain A, Chambers J, Chan CBT, Chan JYM, Chan YC, Chang E, Chang E, Chant T, Chavagnon T, Chellamuthu P, Chen F, Chen J, Chen P, Chen TM, Chen Y, Chen Y, Cheng C, Cheng H, Cheng MC, Cherney D, Cheung AK, Ching CH, Chitalia N, Choksi R, Chukwu C, Chung K, Cianciolo G, Cipressa L, Clark S, Clarke H, Clarke R, Clarke S, Cleveland B, Cole E, Coles H, Condurache L, Connor A, Convery K, Cooper A, Cooper N, Cooper Z, Cooperman L, Cosgrove L, Coutts P, Cowley A, Craik R, Cui G, Cummins T, Dahl N, Dai H, Dajani L, D'Amelio A, Damian E, Damianik K, Danel L, Daniels C, Daniels T, Darbeau S, Darius H, Dasgupta T, Davies J, Davies L, Davis A, Davis J, Davis L, Dayanandan R, Dayi S, Dayrell R, De Nicola L, Debnath S, Deeb W, Degenhardt S, DeGoursey K, Delaney M, Deo R, DeRaad R, Derebail V, Dev D, Devaux M, Dhall P, Dhillon G, Dienes J, Dobre M, Doctolero E, Dodds V, Domingo D, Donaldson D, Donaldson P, Donhauser C, Donley V, Dorestin S, Dorey S, Doulton T, Draganova D, Draxlbauer K, Driver F, Du H, Dube F, Duck T, Dugal T, Dugas J, Dukka H, Dumann H, Durham W, Dursch M, Dykas R, Easow R, Eckrich E, Eden G, Edmerson E, Edwards H, Ee LW, Eguchi J, Ehrl Y, Eichstadt K, Eid W, Eilerman B, Ejima Y, Eldon H, Ellam T, Elliott L, Ellison R, Emberson J, Epp R, Er A, Espino-Obrero M, Estcourt S, Estienne L, Evans G, Evans J, Evans S, Fabbri G, Fajardo-Moser M, Falcone C, Fani F, Faria-Shayler P, Farnia F, Farrugia D, Fechter M, Fellowes D, Feng F, Fernandez J, Ferraro P, Field A, Fikry S, Finch J, Finn H, Fioretto P, Fish R, Fleischer A, Fleming-Brown D, Fletcher L, Flora R, Foellinger C, Foligno N, Forest S, Forghani Z, Forsyth K, Fottrell-Gould D, Fox P, Frankel A, Fraser D, Frazier R, Frederick K, Freking N, French H, Froment A, Fuchs B, Fuessl L, Fujii H, Fujimoto A, Fujita A, Fujita K, Fujita Y, Fukagawa M, Fukao Y, Fukasawa A, Fuller T, Funayama T, Fung E, Furukawa M, Furukawa Y, Furusho M, Gabel S, Gaidu J, Gaiser S, Gallo K, Galloway C, Gambaro G, Gan CC, Gangemi C, Gao M, Garcia K, Garcia M, Garofalo C, Garrity M, Garza A, Gasko S, Gavrila M, Gebeyehu B, Geddes A, Gentile G, George A, George J, Gesualdo L, Ghalli F, Ghanem A, Ghate T, Ghavampour S, Ghazi A, Gherman A, Giebeln-Hudnell U, Gill B, Gillham S, Girakossyan I, Girndt M, Giuffrida A, Glenwright M, Glider T, Gloria R, Glowski D, Goh BL, Goh CB, Gohda T, Goldenberg R, Goldfaden R, Goldsmith C, Golson B, Gonce V, Gong Q, Goodenough B, Goodwin N, Goonasekera M, Gordon A, Gordon J, Gore A, Goto H, Goto S, Goto S, Gowen D, Grace A, Graham J, Grandaliano G, Gray M, Green JB, Greene T, Greenwood G, Grewal B, Grifa R, Griffin D, Griffin S, Grimmer P, Grobovaite E, Grotjahn S, Guerini A, Guest C, Gunda S, Guo B, Guo Q, Haack S, Haase M, Haaser K, Habuki K, Hadley A, Hagan S, Hagge S, Haller H, Ham S, Hamal S, Hamamoto Y, Hamano N, Hamm M, Hanburry A, Haneda M, Hanf C, Hanif W, Hansen J, Hanson L, Hantel S, Haraguchi T, Harding E, Harding T, Hardy C, Hartner C, Harun Z, Harvill L, Hasan A, Hase H, Hasegawa F, Hasegawa T, Hashimoto A, Hashimoto C, Hashimoto M, Hashimoto S, Haskett S, Hauske SJ, Hawfield A, Hayami T, Hayashi M, Hayashi S, Haynes R, Hazara A, Healy C, Hecktman J, Heine G, Henderson H, Henschel R, Hepditch A, Herfurth K, Hernandez G, Hernandez Pena A, Hernandez-Cassis C, Herrington WG, Herzog C, Hewins S, Hewitt D, Hichkad L, Higashi S, Higuchi C, Hill C, Hill L, Hill M, Himeno T, Hing A, Hirakawa Y, Hirata K, Hirota Y, Hisatake T, Hitchcock S, Hodakowski A, Hodge W, Hogan R, Hohenstatt U, Hohenstein B, Hooi L, Hope S, Hopley M, Horikawa S, Hosein D, Hosooka T, Hou L, Hou W, Howie L, Howson A, Hozak M, Htet Z, Hu X, Hu Y, Huang J, Huda N, Hudig L, Hudson A, Hugo C, Hull R, Hume L, Hundei W, Hunt N, Hunter A, Hurley S, Hurst A, Hutchinson C, Hyo T, Ibrahim FH, Ibrahim S, Ihana N, Ikeda T, Imai A, Imamine R, Inamori A, Inazawa H, Ingell J, Inomata K, Inukai Y, Ioka M, Irtiza-Ali A, Isakova T, Isari W, Iselt M, Ishiguro A, Ishihara K, Ishikawa T, Ishimoto T, Ishizuka K, Ismail R, Itano S, Ito H, Ito K, Ito M, Ito Y, Iwagaitsu S, Iwaita Y, Iwakura T, Iwamoto M, Iwasa M, Iwasaki H, Iwasaki S, Izumi K, Izumi K, Izumi T, Jaafar SM, Jackson C, Jackson Y, Jafari G, Jahangiriesmaili M, Jain N, Jansson K, Jasim H, Jeffers L, Jenkins A, Jesky M, Jesus-Silva J, Jeyarajah D, Jiang Y, Jiao X, Jimenez G, Jin B, Jin Q, Jochims J, Johns B, Johnson C, Johnson T, Jolly S, Jones L, Jones L, Jones S, Jones T, Jones V, Joseph M, Joshi S, Judge P, Junejo N, Junus S, Kachele M, Kadowaki T, Kadoya H, Kaga H, Kai H, Kajio H, Kaluza-Schilling W, Kamaruzaman L, Kamarzarian A, Kamimura Y, Kamiya H, Kamundi C, Kan T, Kanaguchi Y, Kanazawa A, Kanda E, Kanegae S, Kaneko K, Kaneko K, Kang HY, Kano T, Karim M, Karounos D, Karsan W, Kasagi R, Kashihara N, Katagiri H, Katanosaka A, Katayama A, Katayama M, Katiman E, Kato K, Kato M, Kato N, Kato S, Kato T, Kato Y, Katsuda Y, Katsuno T, Kaufeld J, Kavak Y, Kawai I, Kawai M, Kawai M, Kawase A, Kawashima S, Kazory A, Kearney J, Keith B, Kellett J, Kelley S, Kershaw M, Ketteler M, Khai Q, Khairullah Q, Khandwala H, Khoo KKL, Khwaja A, Kidokoro K, Kielstein J, Kihara M, Kimber C, Kimura S, Kinashi H, Kingston H, Kinomura M, Kinsella-Perks E, Kitagawa M, Kitajima M, Kitamura S, Kiyosue A, Kiyota M, Klauser F, Klausmann G, Kmietschak W, Knapp K, Knight C, Knoppe A, Knott C, Kobayashi M, Kobayashi R, Kobayashi T, Koch M, Kodama S, Kodani N, Kogure E, Koizumi M, Kojima H, Kojo T, Kolhe N, Komaba H, Komiya T, Komori H, Kon SP, Kondo M, Kondo M, Kong W, Konishi M, Kono K, Koshino M, Kosugi T, Kothapalli B, Kozlowski T, Kraemer B, Kraemer-Guth A, Krappe J, Kraus D, Kriatselis C, Krieger C, Krish P, Kruger B, Ku Md Razi KR, Kuan Y, Kubota S, Kuhn S, Kumar P, Kume S, Kummer I, Kumuji R, Küpper A, Kuramae T, Kurian L, Kuribayashi C, Kurien R, Kuroda E, Kurose T, Kutschat A, Kuwabara N, Kuwata H, La Manna G, Lacey M, Lafferty K, LaFleur P, Lai V, Laity E, Lambert A, Landray MJ, Langlois M, Latif F, Latore E, Laundy E, Laurienti D, Lawson A, Lay M, Leal I, Leal I, Lee AK, Lee J, Lee KQ, Lee R, Lee SA, Lee YY, Lee-Barkey Y, Leonard N, Leoncini G, Leong CM, Lerario S, Leslie A, Levin A, Lewington A, Li J, Li N, Li X, Li Y, Liberti L, Liberti ME, Liew A, Liew YF, Lilavivat U, Lim SK, Lim YS, Limon E, Lin H, Lioudaki E, Liu H, Liu J, Liu L, Liu Q, Liu WJ, Liu X, Liu Z, Loader D, Lochhead H, Loh CL, Lorimer A, Loudermilk L, Loutan J, Low CK, Low CL, Low YM, Lozon Z, Lu Y, Lucci D, Ludwig U, Luker N, Lund D, Lustig R, Lyle S, Macdonald C, MacDougall I, Machicado R, MacLean D, Macleod P, Madera A, Madore F, Maeda K, Maegawa H, Maeno S, Mafham M, Magee J, Maggioni AP, Mah DY, Mahabadi V, Maiguma M, Makita Y, Makos G, Manco L, Mangiacapra R, Manley J, Mann P, Mano S, Marcotte G, Maris J, Mark P, Markau S, Markovic M, Marshall C, Martin M, Martinez C, Martinez S, Martins G, Maruyama K, Maruyama S, Marx K, Maselli A, Masengu A, Maskill A, Masumoto S, Masutani K, Matsumoto M, Matsunaga T, Matsuoka N, Matsushita M, Matthews M, Matthias S, Matvienko E, Maurer M, Maxwell P, Mayne KJ, Mazlan N, Mazlan SA, Mbuyisa A, McCafferty K, McCarroll F, McCarthy T, McClary-Wright C, McCray K, McDermott P, McDonald C, McDougall R, McHaffie E, McIntosh K, McKinley T, McLaughlin S, McLean N, McNeil L, Measor A, Meek J, Mehta A, Mehta R, Melandri M, Mené P, Meng T, Menne J, Merritt K, Merscher S, Meshykhi C, Messa P, Messinger L, Miftari N, Miller R, Miller Y, Miller-Hodges E, Minatoguchi M, Miners M, Minutolo R, Mita T, Miura Y, Miyaji M, Miyamoto S, Miyatsuka T, Miyazaki M, Miyazawa I, Mizumachi R, Mizuno M, Moffat S, Mohamad Nor FS, Mohamad Zaini SN, Mohamed Affandi FA, Mohandas C, Mohd R, Mohd Fauzi NA, Mohd Sharif NH, Mohd Yusoff Y, Moist L, Moncada A, Montasser M, Moon A, Moran C, Morgan N, Moriarty J, Morig G, Morinaga H, Morino K, Morisaki T, Morishita Y, Morlok S, Morris A, Morris F, Mostafa S, Mostefai Y, Motegi M, Motherwell N, Motta D, Mottl A, Moys R, Mozaffari S, Muir J, Mulhern J, Mulligan S, Munakata Y, Murakami C, Murakoshi M, Murawska A, Murphy K, Murphy L, Murray S, Murtagh H, Musa MA, Mushahar L, Mustafa R, Mustafar R, Muto M, Nadar E, Nagano R, Nagasawa T, Nagashima E, Nagasu H, Nagelberg S, Nair H, Nakagawa Y, Nakahara M, Nakamura J, Nakamura R, Nakamura T, Nakaoka M, Nakashima E, Nakata J, Nakata M, Nakatani S, Nakatsuka A, Nakayama Y, Nakhoul G, Nangaku M, Naverrete G, Navivala A, Nazeer I, Negrea L, Nethaji C, Newman E, Ng SYA, Ng TJ, Ngu LLS, Nimbkar T, Nishi H, Nishi M, Nishi S, Nishida Y, Nishiyama A, Niu J, Niu P, Nobili G, Nohara N, Nojima I, Nolan J, Nosseir H, Nozawa M, Nunn M, Nunokawa S, Oda M, Oe M, Oe Y, Ogane K, Ogawa W, Ogihara T, Oguchi G, Ohsugi M, Oishi K, Okada Y, Okajyo J, Okamoto S, Okamura K, Olufuwa O, Oluyombo R, Omata A, Omori Y, Ong LM, Ong YC, Onyema J, Oomatia A, Oommen A, Oremus R, Orimo Y, Ortalda V, Osaki Y, Osawa Y, Osmond Foster J, O'Sullivan A, Otani T, Othman N, Otomo S, O'Toole J, Owen L, Ozawa T, Padiyar A, Page N, Pajak S, Paliege A, Pandey A, Pandey R, Pariani H, Park J, Parrigon M, Passauer J, Patecki M, Patel M, Patel R, Patel T, Patel Z, Paul R, Paul R, Paulsen L, Pavone L, Peixoto A, Peji J, Peng BC, Peng K, Pennino L, Pereira E, Perez E, Pergola P, Pesce F, 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Sabarai A, Saccà C, Sachson R, Sadler E, Safiee NS, Sahani M, Saillant A, Saini J, Saito C, Saito S, Sakaguchi K, Sakai M, Salim H, Salviani C, Sammons E, Sampson A, Samson F, Sandercock P, Sanguila S, Santorelli G, Santoro D, Sarabu N, Saram T, Sardell R, Sasajima H, Sasaki T, Satko S, Sato A, Sato D, Sato H, Sato H, Sato J, Sato T, Sato Y, Satoh M, Sawada K, Schanz M, Scheidemantel F, Schemmelmann M, Schettler E, Schettler V, Schlieper GR, Schmidt C, Schmidt G, Schmidt U, Schmidt-Gurtler H, Schmude M, Schneider A, Schneider I, Schneider-Danwitz C, Schomig M, Schramm T, Schreiber A, Schricker S, Schroppel B, Schulte-Kemna L, Schulz E, Schumacher B, Schuster A, Schwab A, Scolari F, Scott A, Seeger W, Seeger W, Segal M, Seifert L, Seifert M, Sekiya M, Sellars R, Seman MR, Shah S, Shah S, Shainberg L, Shanmuganathan M, Shao F, Sharma K, Sharpe C, Sheikh-Ali M, Sheldon J, Shenton C, Shepherd A, Shepperd M, Sheridan R, Sheriff Z, Shibata Y, Shigehara T, Shikata K, Shimamura K, Shimano H, 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Effects of empagliflozin on progression of chronic kidney disease: a prespecified secondary analysis from the empa-kidney trial. Lancet Diabetes Endocrinol 2024; 12:39-50. [PMID: 38061371 PMCID: PMC7615591 DOI: 10.1016/s2213-8587(23)00321-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 10/24/2023] [Accepted: 10/25/2023] [Indexed: 12/23/2023]
Abstract
BACKGROUND Sodium-glucose co-transporter-2 (SGLT2) inhibitors reduce progression of chronic kidney disease and the risk of cardiovascular morbidity and mortality in a wide range of patients. However, their effects on kidney disease progression in some patients with chronic kidney disease are unclear because few clinical kidney outcomes occurred among such patients in the completed trials. In particular, some guidelines stratify their level of recommendation about who should be treated with SGLT2 inhibitors based on diabetes status and albuminuria. We aimed to assess the effects of empagliflozin on progression of chronic kidney disease both overall and among specific types of participants in the EMPA-KIDNEY trial. METHODS EMPA-KIDNEY, a randomised, controlled, phase 3 trial, was conducted at 241 centres in eight countries (Canada, China, Germany, Italy, Japan, Malaysia, the UK, and the USA), and included individuals aged 18 years or older with an estimated glomerular filtration rate (eGFR) of 20 to less than 45 mL/min per 1·73 m2, or with an eGFR of 45 to less than 90 mL/min per 1·73 m2 with a urinary albumin-to-creatinine ratio (uACR) of 200 mg/g or higher. We explored the effects of 10 mg oral empagliflozin once daily versus placebo on the annualised rate of change in estimated glomerular filtration rate (eGFR slope), a tertiary outcome. We studied the acute slope (from randomisation to 2 months) and chronic slope (from 2 months onwards) separately, using shared parameter models to estimate the latter. Analyses were done in all randomly assigned participants by intention to treat. EMPA-KIDNEY is registered at ClinicalTrials.gov, NCT03594110. FINDINGS Between May 15, 2019, and April 16, 2021, 6609 participants were randomly assigned and then followed up for a median of 2·0 years (IQR 1·5-2·4). Prespecified subgroups of eGFR included 2282 (34·5%) participants with an eGFR of less than 30 mL/min per 1·73 m2, 2928 (44·3%) with an eGFR of 30 to less than 45 mL/min per 1·73 m2, and 1399 (21·2%) with an eGFR 45 mL/min per 1·73 m2 or higher. Prespecified subgroups of uACR included 1328 (20·1%) with a uACR of less than 30 mg/g, 1864 (28·2%) with a uACR of 30 to 300 mg/g, and 3417 (51·7%) with a uACR of more than 300 mg/g. Overall, allocation to empagliflozin caused an acute 2·12 mL/min per 1·73 m2 (95% CI 1·83-2·41) reduction in eGFR, equivalent to a 6% (5-6) dip in the first 2 months. After this, it halved the chronic slope from -2·75 to -1·37 mL/min per 1·73 m2 per year (relative difference 50%, 95% CI 42-58). The absolute and relative benefits of empagliflozin on the magnitude of the chronic slope varied significantly depending on diabetes status and baseline levels of eGFR and uACR. In particular, the absolute difference in chronic slopes was lower in patients with lower baseline uACR, but because this group progressed more slowly than those with higher uACR, this translated to a larger relative difference in chronic slopes in this group (86% [36-136] reduction in the chronic slope among those with baseline uACR <30 mg/g compared with a 29% [19-38] reduction for those with baseline uACR ≥2000 mg/g; ptrend<0·0001). INTERPRETATION Empagliflozin slowed the rate of progression of chronic kidney disease among all types of participant in the EMPA-KIDNEY trial, including those with little albuminuria. Albuminuria alone should not be used to determine whether to treat with an SGLT2 inhibitor. FUNDING Boehringer Ingelheim and Eli Lilly.
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Nakahara M, Nakamura J, Nakamura R, Nakamura T, Nakaoka M, Nakashima E, Nakata J, Nakata M, Nakatani S, Nakatsuka A, Nakayama Y, Nakhoul G, Nangaku M, Naverrete G, Navivala A, Nazeer I, Negrea L, Nethaji C, Newman E, Ng SYA, Ng TJ, Ngu LLS, Nimbkar T, Nishi H, Nishi M, Nishi S, Nishida Y, Nishiyama A, Niu J, Niu P, Nobili G, Nohara N, Nojima I, Nolan J, Nosseir H, Nozawa M, Nunn M, Nunokawa S, Oda M, Oe M, Oe Y, Ogane K, Ogawa W, Ogihara T, Oguchi G, Ohsugi M, Oishi K, Okada Y, Okajyo J, Okamoto S, Okamura K, Olufuwa O, Oluyombo R, Omata A, Omori Y, Ong LM, Ong YC, Onyema J, Oomatia A, Oommen A, Oremus R, Orimo Y, Ortalda V, Osaki Y, Osawa Y, Osmond Foster J, O'Sullivan A, Otani T, Othman N, Otomo S, O'Toole J, Owen L, Ozawa T, Padiyar A, Page N, Pajak S, Paliege A, Pandey A, Pandey R, Pariani H, Park J, Parrigon M, Passauer J, Patecki M, Patel M, Patel R, Patel T, Patel Z, Paul R, Paul R, Paulsen L, Pavone L, Peixoto A, Peji J, Peng BC, Peng K, Pennino L, Pereira E, Perez E, Pergola P, Pesce F, Pessolano G, Petchey W, Petr EJ, Pfab T, Phelan P, Phillips R, Phillips T, Phipps M, Piccinni G, Pickett T, Pickworth S, Piemontese M, Pinto D, Piper J, Plummer-Morgan J, Poehler D, Polese L, Poma V, Pontremoli R, Postal A, Pötz C, Power A, Pradhan N, Pradhan R, Preiss D, Preiss E, Preston K, Prib N, Price L, Provenzano C, Pugay C, Pulido R, Putz F, Qiao Y, Quartagno R, Quashie-Akponeware M, Rabara R, Rabasa-Lhoret R, Radhakrishnan D, Radley M, Raff R, Raguwaran S, Rahbari-Oskoui F, Rahman M, Rahmat K, Ramadoss S, Ramanaidu S, Ramasamy S, Ramli R, Ramli S, Ramsey T, Rankin A, Rashidi A, Raymond L, Razali WAFA, Read K, Reiner H, Reisler A, Reith C, Renner J, Rettenmaier B, Richmond L, Rijos D, Rivera R, Rivers V, Robinson H, Rocco M, Rodriguez-Bachiller I, Rodriquez R, Roesch C, Roesch J, Rogers J, Rohnstock M, Rolfsmeier S, Roman M, Romo A, Rosati A, Rosenberg S, Ross T, Rossello X, Roura M, Roussel M, Rovner S, Roy S, Rucker S, Rump L, Ruocco M, Ruse S, Russo F, Russo M, Ryder M, Sabarai A, Saccà C, Sachson R, Sadler E, Safiee NS, Sahani M, Saillant A, Saini J, Saito C, Saito S, Sakaguchi K, Sakai M, Salim H, Salviani C, Sammons E, Sampson A, Samson F, Sandercock P, Sanguila S, Santorelli G, Santoro D, Sarabu N, Saram T, Sardell R, Sasajima H, Sasaki T, Satko S, Sato A, Sato D, Sato H, Sato H, Sato J, Sato T, Sato Y, Satoh M, Sawada K, Schanz M, Scheidemantel F, Schemmelmann M, Schettler E, Schettler V, Schlieper GR, Schmidt C, Schmidt G, Schmidt U, Schmidt-Gurtler H, Schmude M, Schneider A, Schneider I, Schneider-Danwitz C, Schomig M, Schramm T, Schreiber A, Schricker S, Schroppel B, Schulte-Kemna L, Schulz E, Schumacher B, Schuster A, Schwab A, Scolari F, Scott A, Seeger W, Seeger W, Segal M, Seifert L, Seifert M, Sekiya M, Sellars R, Seman MR, Shah S, Shah S, Shainberg L, Shanmuganathan M, Shao F, Sharma K, Sharpe C, Sheikh-Ali M, Sheldon J, Shenton C, Shepherd A, Shepperd M, Sheridan R, Sheriff Z, Shibata Y, Shigehara T, Shikata K, Shimamura K, Shimano H, Shimizu Y, Shimoda H, Shin K, Shivashankar G, Shojima N, Silva R, Sim CSB, Simmons K, Sinha S, Sitter T, Sivanandam S, Skipper M, Sloan K, Sloan L, Smith R, Smyth J, Sobande T, Sobata M, Somalanka S, Song X, Sonntag F, Sood B, Sor SY, Soufer J, Sparks H, Spatoliatore G, Spinola T, Squyres S, Srivastava A, Stanfield J, Staplin N, Staylor K, Steele A, Steen O, Steffl D, Stegbauer J, Stellbrink C, Stellbrink E, Stevens W, Stevenson A, Stewart-Ray V, Stickley J, Stoffler D, Stratmann B, Streitenberger S, Strutz F, Stubbs J, Stumpf J, Suazo N, Suchinda P, Suckling R, Sudin A, Sugamori K, Sugawara H, Sugawara K, Sugimoto D, Sugiyama H, Sugiyama H, Sugiyama T, Sullivan M, Sumi M, Suresh N, Sutton D, Suzuki H, Suzuki R, Suzuki Y, Suzuki Y, Suzuki Y, Swanson E, Swift P, Syed S, Szerlip H, Taal M, Taddeo M, Tailor C, Tajima K, Takagi M, Takahashi K, Takahashi K, Takahashi M, Takahashi T, Takahira E, Takai T, Takaoka M, Takeoka J, Takesada A, Takezawa M, Talbot M, Taliercio J, Talsania T, Tamori Y, Tamura R, Tamura Y, Tan CHH, Tan EZZ, Tanabe A, Tanabe K, Tanaka A, Tanaka A, Tanaka N, Tang S, Tang Z, Tanigaki K, Tarlac M, Tatsuzawa A, Tay JF, Tay LL, Taylor J, Taylor K, Taylor K, Te A, Tenbusch L, Teng KS, Terakawa A, Terry J, Tham ZD, Tholl S, Thomas G, Thong KM, Tietjen D, Timadjer A, Tindall H, Tipper S, Tobin K, Toda N, Tokuyama A, Tolibas M, Tomita A, Tomita T, Tomlinson J, Tonks L, Topf J, Topping S, Torp A, Torres A, Totaro F, Toth P, Toyonaga Y, Tripodi F, Trivedi K, Tropman E, Tschope D, Tse J, Tsuji K, Tsunekawa S, Tsunoda R, Tucky B, Tufail S, Tuffaha A, Turan E, Turner H, Turner J, Turner M, Tuttle KR, Tye YL, Tyler A, Tyler J, Uchi H, Uchida H, Uchida T, Uchida T, Udagawa T, Ueda S, Ueda Y, Ueki K, Ugni S, Ugwu E, Umeno R, Unekawa C, Uozumi K, Urquia K, Valleteau A, Valletta C, van Erp R, Vanhoy C, Varad V, Varma R, Varughese A, Vasquez P, Vasseur A, Veelken R, Velagapudi C, Verdel K, Vettoretti S, Vezzoli G, Vielhauer V, Viera R, Vilar E, Villaruel S, Vinall L, Vinathan J, Visnjic M, Voigt E, von-Eynatten M, Vourvou M, Wada J, Wada J, Wada T, Wada Y, Wakayama K, Wakita Y, Wallendszus K, Walters T, Wan Mohamad WH, Wang L, Wang W, Wang X, Wang X, Wang Y, Wanner C, Wanninayake S, Watada H, Watanabe K, Watanabe K, Watanabe M, Waterfall H, Watkins D, Watson S, Weaving L, Weber B, Webley Y, Webster A, Webster M, Weetman M, Wei W, Weihprecht H, Weiland L, Weinmann-Menke J, Weinreich T, Wendt R, Weng Y, Whalen M, Whalley G, Wheatley R, Wheeler A, Wheeler J, Whelton P, White K, Whitmore B, Whittaker S, Wiebel J, Wiley J, Wilkinson L, Willett M, Williams A, Williams E, Williams K, Williams T, Wilson A, Wilson P, Wincott L, Wines E, Winkelmann B, Winkler M, Winter-Goodwin B, Witczak J, Wittes J, Wittmann M, Wolf G, Wolf L, Wolfling R, Wong C, Wong E, Wong HS, Wong LW, Wong YH, Wonnacott A, Wood A, Wood L, Woodhouse H, Wooding N, Woodman A, Wren K, Wu J, Wu P, Xia S, Xiao H, Xiao X, Xie Y, Xu C, Xu Y, Xue H, Yahaya H, Yalamanchili H, Yamada A, Yamada N, Yamagata K, Yamaguchi M, Yamaji Y, Yamamoto A, Yamamoto S, Yamamoto S, Yamamoto T, Yamanaka A, Yamano T, Yamanouchi Y, Yamasaki N, Yamasaki Y, Yamasaki Y, Yamashita C, Yamauchi T, Yan Q, Yanagisawa E, Yang F, Yang L, Yano S, Yao S, Yao Y, Yarlagadda S, Yasuda Y, Yiu V, Yokoyama T, Yoshida S, Yoshidome E, Yoshikawa H, Young A, Young T, Yousif V, Yu H, Yu Y, Yuasa K, Yusof N, Zalunardo N, Zander B, Zani R, Zappulo F, Zayed M, Zemann B, Zettergren P, Zhang H, Zhang L, Zhang L, Zhang N, Zhang X, Zhao J, Zhao L, Zhao S, Zhao Z, Zhong H, Zhou N, Zhou S, Zhu D, Zhu L, Zhu S, Zietz M, Zippo M, Zirino F, Zulkipli FH. Impact of primary kidney disease on the effects of empagliflozin in patients with chronic kidney disease: secondary analyses of the EMPA-KIDNEY trial. Lancet Diabetes Endocrinol 2024; 12:51-60. [PMID: 38061372 DOI: 10.1016/s2213-8587(23)00322-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 10/24/2023] [Accepted: 10/25/2023] [Indexed: 12/23/2023]
Abstract
BACKGROUND The EMPA-KIDNEY trial showed that empagliflozin reduced the risk of the primary composite outcome of kidney disease progression or cardiovascular death in patients with chronic kidney disease mainly through slowing progression. We aimed to assess how effects of empagliflozin might differ by primary kidney disease across its broad population. METHODS EMPA-KIDNEY, a randomised, controlled, phase 3 trial, was conducted at 241 centres in eight countries (Canada, China, Germany, Italy, Japan, Malaysia, the UK, and the USA). Patients were eligible if their estimated glomerular filtration rate (eGFR) was 20 to less than 45 mL/min per 1·73 m2, or 45 to less than 90 mL/min per 1·73 m2 with a urinary albumin-to-creatinine ratio (uACR) of 200 mg/g or higher at screening. They were randomly assigned (1:1) to 10 mg oral empagliflozin once daily or matching placebo. Effects on kidney disease progression (defined as a sustained ≥40% eGFR decline from randomisation, end-stage kidney disease, a sustained eGFR below 10 mL/min per 1·73 m2, or death from kidney failure) were assessed using prespecified Cox models, and eGFR slope analyses used shared parameter models. Subgroup comparisons were performed by including relevant interaction terms in models. EMPA-KIDNEY is registered with ClinicalTrials.gov, NCT03594110. FINDINGS Between May 15, 2019, and April 16, 2021, 6609 participants were randomly assigned and followed up for a median of 2·0 years (IQR 1·5-2·4). Prespecified subgroupings by primary kidney disease included 2057 (31·1%) participants with diabetic kidney disease, 1669 (25·3%) with glomerular disease, 1445 (21·9%) with hypertensive or renovascular disease, and 1438 (21·8%) with other or unknown causes. Kidney disease progression occurred in 384 (11·6%) of 3304 patients in the empagliflozin group and 504 (15·2%) of 3305 patients in the placebo group (hazard ratio 0·71 [95% CI 0·62-0·81]), with no evidence that the relative effect size varied significantly by primary kidney disease (pheterogeneity=0·62). The between-group difference in chronic eGFR slopes (ie, from 2 months to final follow-up) was 1·37 mL/min per 1·73 m2 per year (95% CI 1·16-1·59), representing a 50% (42-58) reduction in the rate of chronic eGFR decline. This relative effect of empagliflozin on chronic eGFR slope was similar in analyses by different primary kidney diseases, including in explorations by type of glomerular disease and diabetes (p values for heterogeneity all >0·1). INTERPRETATION In a broad range of patients with chronic kidney disease at risk of progression, including a wide range of non-diabetic causes of chronic kidney disease, empagliflozin reduced risk of kidney disease progression. Relative effect sizes were broadly similar irrespective of the cause of primary kidney disease, suggesting that SGLT2 inhibitors should be part of a standard of care to minimise risk of kidney failure in chronic kidney disease. FUNDING Boehringer Ingelheim, Eli Lilly, and UK Medical Research Council.
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Ibrahim S, Sathar J. Is There a Doctor on Board? We Have an Emergency! Malays Orthop J 2023; 17:99-100. [PMID: 38107349 PMCID: PMC10723006 DOI: 10.5704/moj.2311.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Accepted: 09/21/2023] [Indexed: 12/19/2023] Open
Affiliation(s)
- S Ibrahim
- Paediatric Orthopaedic Uni, UKM Specialist Children's Hospital, Kuala Lumpur, Malaysia
| | - J Sathar
- Department of Haematology, Ampang Hospital, Ampang, Malaysia
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Newman JG, Ibrahim S, Ruiz ES, Prasai A, Siegel J, Fitzgerald A, Goldberg M, Koyfman SA. Risk-Stratification using the 40-Gene Expression Profile (40-GEP) Test Identifies Patients with Node Negative Cutaneous Squamous Cell Carcinoma (cSCC) at Higher Risk of Metastasis Who May Benefit from Adjuvant Radiation Therapy (ART). Int J Radiat Oncol Biol Phys 2023; 117:S153. [PMID: 37784387 DOI: 10.1016/j.ijrobp.2023.06.575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) ART is a standard treatment used to reduce the risk of metastasis and recurrence in moderate‒to‒high-risk cSCC patients. Indications for ART have been largely based on pathologic risk factors and informed by staging systems, and while radiation oncologists generally designate a >10% risk threshold for usage of ART, there is no consensus on which groups of tumors may benefit from ART. The 40-GEP test has been independently validated to predict a cSCC patient's risk for regional/distant metastasis in patients with one or more high-risk clinicopathologic factors and reports three biologic risk groups: Class 1 (low, ∼7%), Class 2A (moderate, 20-25%), and Class 2B (high risk, >50%) for metastasis. This study aims to evaluate whether a biomarker informed risk stratification approach using a 40-GEP result could refine the ability to select patients with node negative cSCC at higher risk of metastasis who are most likely to benefit from ART. MATERIALS/METHODS In this retrospective study, all patients had primary cSCC tissue with verified clinicopathologic information of tumors with one or more high-risk factors, met clinical testing criteria, were comprehensively staged, and had outcomes data (n = 954). Patients with node positive disease, or those with nodal failure within 3 months of diagnosis were excluded (n = 19). From the n = 935, an intermediate risk population wherein ART is often considered was defined as Brigham and Women's Hospital (BWH) ≥T2a (n = 489). Kaplan-Meier survival analysis and log-rank test were used to assess metastasis free survival (MFS). Univariate Cox regression compared metastasis rates between 40-GEP results. RESULTS The 3-year MFS rate for this eligible for ART cohort was 82.4% The 40-GEP demonstrated statistically significant risk stratification with MFS rates of 92.4%, 76.1% and 59.4% for Class 1, Class 2A and Class 2B, respectively (p<0.0001). Cox regression was significant for Class 2A and 2B compared to Class 1, with a 3.2-fold and 6.4-fold increase in metastasis, respectively (p<0.0001). 64% (59/92) of all metastases received a Class 2A result, and 44% (14/32) of Class 2B patients metastasized. 46% (223/489) of the cohort received a Class 1 result. Of patients staged BWH T1 (n = 446), those with a Class 2A and 2B had an 88.7% and 66.7% MFS rate, respectively. CONCLUSION Within this eligible for ART population, patients with Class 2A or 2B 40-GEP results have inferior rates of MFS, while Class 1 patients have <10% risk of metastasis. Nearly half of this population received a 40-GEP Class 1 result and could be considered for treatment de-intensification trials. Conversely, patients with low-risk BWH T1 stage, who are traditionally not considered for ART, that received a Class 2A or 2B (>10% risk of metastasis) could be considered for adjuvant therapy.
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Affiliation(s)
- J G Newman
- Department of Otorhinolaryngology: Head and Neck Surgery, Medical University of South Carolina, Charleston, SC
| | - S Ibrahim
- Rochester Dermatologic Surgery, Victor, NY
| | - E S Ruiz
- Department of Dermatology, Dana-Farber/Brigham & Women's Cancer Center, Boston, MA
| | - A Prasai
- Castle Biosciences Inc., Friendswood, TX
| | - J Siegel
- Castle Biosciences Inc., Friendswood, TX
| | | | - M Goldberg
- Castle Biosciences Inc., Friendswood, TX
| | - S A Koyfman
- Department of Radiation Oncology, Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH
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Rodway C, Tham SG, Richards N, Ibrahim S, Turnbull P, Kapur N, Appleby L. Online harms? Suicide-related online experience: a UK-wide case series study of young people who die by suicide. Psychol Med 2023; 53:4434-4445. [PMID: 35587034 PMCID: PMC10388316 DOI: 10.1017/s0033291722001258] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 02/22/2022] [Accepted: 04/14/2022] [Indexed: 11/07/2022]
Abstract
BACKGROUND Few studies have examined online experience by young people who die by suicide. METHODS A 3-year UK-wide consecutive case series of all young people aged 10-19 who died by suicide, based on national mortality data. We extracted information on the antecedents of suicide of 544 of these 595 deaths (91%) from official investigations, mainly inquests. RESULTS Suicide-related online experience was reported in 24% (n = 128/544) of suicide deaths in young people between 2014 and 2016, equivalent to 43 deaths per year, and was more common in girls than boys (OR 1.87, 95% CI 1.23-2.85, p = 0.003) and those identifying as LGBT (OR 2.35, 95% CI 1.10-5.05, p = 0.028). Searching for information about method was most common (n = 68, 13%), followed by posting suicidal ideas online (n = 57, 10%). Self-harm, bereavement (especially by suicide), social isolation, and mental and physical ill-health were more likely in those known to have suicide-related online experience compared to those who did not. 29 (5%) were bullied online, more often girls (OR 2.84, 1.34-6.04, p = 0.007). Online bullying often accompanied face-to-face bullying (n = 16/29, 67%). CONCLUSIONS Suicide-related online experience is a common, but likely underestimated, antecedent to suicide in young people. Although its causal role is unclear, it may influence suicidality in this population. Mental health professionals should be aware that suicide-related online experience - not limited to social media - is a potential risk for young patients, and may be linked to experiences offline. For public health, wider action is required on internet regulation and support for children and their families.
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Affiliation(s)
- C. Rodway
- National Confidential Inquiry into Suicide and Safety in Mental Health (NCISH), Centre for Mental Health and Safety, School of Health Sciences, The University of Manchester, 2nd Floor Jean McFarlane Building, Oxford Road, Manchester, M13 9PL UK
| | - S. G. Tham
- National Confidential Inquiry into Suicide and Safety in Mental Health (NCISH), Centre for Mental Health and Safety, School of Health Sciences, The University of Manchester, 2nd Floor Jean McFarlane Building, Oxford Road, Manchester, M13 9PL UK
| | - N. Richards
- National Confidential Inquiry into Suicide and Safety in Mental Health (NCISH), Centre for Mental Health and Safety, School of Health Sciences, The University of Manchester, 2nd Floor Jean McFarlane Building, Oxford Road, Manchester, M13 9PL UK
| | - S. Ibrahim
- National Confidential Inquiry into Suicide and Safety in Mental Health (NCISH), Centre for Mental Health and Safety, School of Health Sciences, The University of Manchester, 2nd Floor Jean McFarlane Building, Oxford Road, Manchester, M13 9PL UK
| | - P. Turnbull
- National Confidential Inquiry into Suicide and Safety in Mental Health (NCISH), Centre for Mental Health and Safety, School of Health Sciences, The University of Manchester, 2nd Floor Jean McFarlane Building, Oxford Road, Manchester, M13 9PL UK
| | - N. Kapur
- National Confidential Inquiry into Suicide and Safety in Mental Health (NCISH), Centre for Mental Health and Safety, School of Health Sciences, The University of Manchester, 2nd Floor Jean McFarlane Building, Oxford Road, Manchester, M13 9PL UK
| | - L. Appleby
- National Confidential Inquiry into Suicide and Safety in Mental Health (NCISH), Centre for Mental Health and Safety, School of Health Sciences, The University of Manchester, 2nd Floor Jean McFarlane Building, Oxford Road, Manchester, M13 9PL UK
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Chung CJ, Hermes BM, Gupta Y, Ibrahim S, Belheouane M, Baines JF. Genome-wide mapping of gene-microbe interactions in the murine lung microbiota based on quantitative microbial profiling. Anim Microbiome 2023; 5:31. [PMID: 37264412 DOI: 10.1186/s42523-023-00250-y] [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: 11/22/2022] [Accepted: 05/10/2023] [Indexed: 06/03/2023] Open
Abstract
BACKGROUND Mammalian lungs comprise a complex microbial ecosystem that interacts with host physiology. Previous research demonstrates that the environment significantly contributes to bacterial community structure in the upper and lower respiratory tract. However, the influence of host genetics on the makeup of lung microbiota remains ambiguous, largely due to technical difficulties related to sampling, as well as challenges inherent to investigating low biomass communities. Thus, innovative approaches are warranted to clarify host-microbe interactions in the mammalian lung. RESULTS Here, we aimed to characterize host genomic regions associated with lung bacterial traits in an advanced intercross mouse line (AIL). By performing quantitative microbial profiling (QMP) using the highly precise method of droplet digital PCR (ddPCR), we refined 16S rRNA gene amplicon-based traits to identify and map candidate lung-resident taxa using a QTL mapping approach. In addition, the two abundant core taxa Lactobacillus and Pelomonas were chosen for independent microbial phenotyping using genus-specific primers. In total, this revealed seven significant loci involving eight bacterial traits. The narrow confidence intervals afforded by the AIL population allowed us to identify several promising candidate genes related to immune and inflammatory responses, cell apoptosis, DNA repair, and lung functioning and disease susceptibility. Interestingly, one genomic region associated with Lactobacillus abundance contains the well-known anti-inflammatory cytokine Il10, which we confirmed through the analysis of Il10 knockout mice. CONCLUSIONS Our study provides the first evidence for a role of host genetic variation contributing to variation in the lung microbiota. This was in large part made possible through the careful curation of 16S rRNA gene amplicon data and the incorporation of a QMP-based methods. This approach to evaluating the low biomass lung environment opens new avenues for advancing lung microbiome research using animal models.
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Affiliation(s)
- C J Chung
- Max Planck Institute for Evolutionary Biology, August-Thienemann-Str. 2, 24306, Plön, Germany
- Section of Evolutionary Medicine, Institute for Experimental Medicine, Kiel University, Arnold-Heller-Str. 3, 24105, Kiel, Germany
| | - B M Hermes
- Max Planck Institute for Evolutionary Biology, August-Thienemann-Str. 2, 24306, Plön, Germany
- Section of Evolutionary Medicine, Institute for Experimental Medicine, Kiel University, Arnold-Heller-Str. 3, 24105, Kiel, Germany
| | - Y Gupta
- Division of Nephrology, Department of Medicine, Columbia University Irving Medical Center, New York, NY, 10032, USA
| | - S Ibrahim
- College of Medicine and Health Sciences, Khalifa University, Abu Dhabi, UAE
| | - Meriem Belheouane
- Max Planck Institute for Evolutionary Biology, August-Thienemann-Str. 2, 24306, Plön, Germany.
- Section of Evolutionary Medicine, Institute for Experimental Medicine, Kiel University, Arnold-Heller-Str. 3, 24105, Kiel, Germany.
- Research Center Borstel, Evolution of the Resistome, Leibniz Lung Center, Parkallee 1-40, 23845, Borstel, Germany.
| | - John F Baines
- Max Planck Institute for Evolutionary Biology, August-Thienemann-Str. 2, 24306, Plön, Germany.
- Section of Evolutionary Medicine, Institute for Experimental Medicine, Kiel University, Arnold-Heller-Str. 3, 24105, Kiel, Germany.
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Miroshnychenko A, Ibrahim S, Azab M, Roldan Y, Martinez J, Tamilselvan D, He L, Little J, Urquhart O, Tampi M, Polk D, Moore P, Hersh E, Claytor B, Carrasco-Labra A, Brignardello-Petersen R. Acute Postoperative Pain Due to Dental Extraction in the Adult Population: A Systematic Review and Network Meta-analysis. J Dent Res 2023; 102:391-401. [PMID: 36631957 PMCID: PMC10031629 DOI: 10.1177/00220345221139230] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [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] [Indexed: 01/12/2023] Open
Abstract
This study compares the effectiveness of pharmacological treatments to develop guidelines for the management of acute pain after tooth extraction. We searched Medline, EMBASE, CENTRAL, and US Clinical Trials registry on November 21, 2020. We included randomized clinical trials (RCTs) of participants undergoing dental extractions comparing 10 interventions, including acetaminophen, nonsteroidal anti-inflammatory drugs (NSAIDs), opioids, and combinations to placebo. After duplicate screening and data abstraction, we conducted a frequentist network meta-analysis for each outcome at 6 h (i.e., pain relief, total pain relief [TOTPAR], summed pain intensity difference [SPID], global efficacy rating, rescue analgesia, and adverse effects). We assessed the risk of bias using a modified Cochrane RoB 2.0 tool and the certainty of evidence using the Grading of Recommendations, Assessment, Development, and Evaluation approach. We implemented the analyses in RStudio version 3.5.3 and classified interventions from most to least beneficial or harmful. We included 82 RCTs. Fifty-six RCTs enrolling 9,095 participants found moderate- and high-certainty evidence that ibuprofen 200 to 400 mg plus acetaminophen 500 to 1,000 mg (mean difference compared to placebo [MDp], 1.68; 95% confidence interval [CI], 1.06-2.31), acetaminophen 650 mg plus oxycodone 10 mg (MDp, 1.19; 95% CI, 0.85-1.54), ibuprofen 400 mg (MDp, 1.31; 95% CI, 1.17-1.45), and naproxen 400-440 mg (MDp, 1.44; 95% CI, 1.07-1.80) were most effective for pain relief on a 0 to 4 scale. Oxycodone 5 mg, codeine 60 mg, and tramadol 37.5 mg plus acetaminophen 325 mg were no better than placebo. The results for TOTPAR, SPID, global efficacy rating, and rescue analgesia were similar. Based on low- and very low-certainty evidence, most interventions were classified as no more harmful than placebo for most adverse effects. Based on moderate- and high-certainty evidence, NSAIDs with or without acetaminophen result in better pain-related outcomes than opioids with or without acetaminophen (except acetaminophen 650 mg plus oxycodone 10 mg) or placebo.
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Affiliation(s)
- A. Miroshnychenko
- Department of Health Research Methods,
Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
| | - S. Ibrahim
- Faculty of Health Sciences, McMaster
University, Hamilton, Ontario, Canada
| | - M. Azab
- Faculty of Health Sciences, McMaster
University, Hamilton, Ontario, Canada
| | - Y. Roldan
- Department of Health Research Methods,
Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
| | - J.P.D. Martinez
- Department of Health Research Methods,
Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
| | - D. Tamilselvan
- Faculty of Health Sciences, McMaster
University, Hamilton, Ontario, Canada
| | - L. He
- Faculty of Health Sciences, McMaster
University, Hamilton, Ontario, Canada
| | - J.W. Little
- Division of Oral and Craniofacial
Health Sciences, Adams School of Dentistry, Chapel Hill, NC, USA
| | - O. Urquhart
- ADA Science and Research Institute,
Chicago, Illinois, USA
| | - M. Tampi
- Department of Cariology, University of
Michigan School of Dentistry, Ann Arbor, MI, USA
| | - D.E. Polk
- Department of Dental Public Health,
University of Pittsburgh, Pittsburgh, PA, USA
| | - P.A. Moore
- Department of Dental Public Health,
University of Pittsburgh, Pittsburgh, PA, USA
| | - E.V. Hersh
- Department of Oral Surgery and
Pharmacology, University of Pennsylvania, Philadelphia, PA, USA
| | - B. Claytor
- N.C. Caring Dental Professionals,
Aberdeen, NC, USA
| | - A. Carrasco-Labra
- Department of Preventative and
Restorative Sciences, University of Pennsylvania, Philadelphia, PA, USA
| | - R. Brignardello-Petersen
- Department of Health Research Methods,
Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
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11
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Hassan S, Paudyal N, Emaan A, Ibrahim S. Monkeypox Virus: A comprehensive narrative review. Kathmandu Univ Med J (KUMJ) 2023; 21:86-93. [PMID: 37800433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/07/2023]
Abstract
Monkeypox virus, now known as Mpox virus is a large, enveloped, double stranded deoxyribonucleic acid (DNA) virus belonging to the Orthopox viridae genus of the Poxviridae family. Though, Mpox, have earlier been endemic to only African countries, the 2022 outbreak has shown its rapid spread throughout the world. The May 2022 outbreak have shown primarily human to human transmission in contrast to animal to human transmission that had been seen previously. Recent data also suggest a possibility of a pre symptomatic spread. After an incubation period of 9 days, patients with Mpox can present with a prodrome of symptoms followed by a rash. If untreated, severe complications develop in the high-risk groups especially children and pregnant woman. Such groups of people will benefit from antiviral treatments. The current approach to prevent against it is pre-exposure and post exposure prophylaxis with vaccines. The vaccines that have been approved by Food and Drug Administration to date is ACAM2000 and JYNNEOS. Several diagnostic methods exist, among which polymerase chain reaction has proven to be the most specific and sensitive. In this review, we will discuss its epidemiology, the clinical manifestations, diagnostic modalities, complications, treatment approaches and preventive measures.
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Affiliation(s)
- S Hassan
- Nobel Medical College Teaching Hospital, Kanchanbari, Morang, Biratnagar
| | - N Paudyal
- Nobel Medical College Teaching Hospital, Kanchanbari, Morang, Biratnagar
| | - A Emaan
- Nobel Medical College Teaching Hospital, Kanchanbari, Morang, Biratnagar
| | - S Ibrahim
- Nobel Medical College Teaching Hospital, Kanchanbari, Morang, Biratnagar
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12
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Kossmann DF, Huang M, Weihmann R, Xiao X, Gätgens F, Weber TM, Brass HUC, Bitzenhofer NL, Ibrahim S, Bangert K, Rehling L, Mueller C, Tiso T, Blank LM, Drepper T, Jaeger KE, Grundler FMW, Pietruszka J, Schleker ASS, Loeschcke A. Production of tailored hydroxylated prodiginine showing combinatorial activity with rhamnolipids against plant-parasitic nematodes. Front Microbiol 2023; 14:1151882. [PMID: 37200918 PMCID: PMC10187637 DOI: 10.3389/fmicb.2023.1151882] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Accepted: 04/03/2023] [Indexed: 05/20/2023] Open
Abstract
Bacterial secondary metabolites exhibit diverse remarkable bioactivities and are thus the subject of study for different applications. Recently, the individual effectiveness of tripyrrolic prodiginines and rhamnolipids against the plant-parasitic nematode Heterodera schachtii, which causes tremendous losses in crop plants, was described. Notably, rhamnolipid production in engineered Pseudomonas putida strains has already reached industrial implementation. However, the non-natural hydroxyl-decorated prodiginines, which are of particular interest in this study due to a previously described particularly good plant compatibility and low toxicity, are not as readily accessible. In the present study, a new effective hybrid synthetic route was established. This included the engineering of a novel P. putida strain to provide enhanced levels of a bipyrrole precursor and an optimization of mutasynthesis, i.e., the conversion of chemically synthesized and supplemented monopyrroles to tripyrrolic compounds. Subsequent semisynthesis provided the hydroxylated prodiginine. The prodiginines caused reduced infectiousness of H. schachtii for Arabidopsis thaliana plants resulting from impaired motility and stylet thrusting, providing the first insights on the mode of action in this context. Furthermore, the combined application with rhamnolipids was assessed for the first time and found to be more effective against nematode parasitism than the individual compounds. To obtain, for instance, 50% nematode control, it was sufficient to apply 7.8 μM hydroxylated prodiginine together with 0.7 μg/ml (~ 1.1 μM) di-rhamnolipids, which corresponded to ca. ¼ of the individual EC50 values. In summary, a hybrid synthetic route toward a hydroxylated prodiginine was established and its effects and combinatorial activity with rhamnolipids on plant-parasitic nematode H. schachtii are presented, demonstrating potential application as antinematodal agents. Graphical Abstract.
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Affiliation(s)
- D. F. Kossmann
- Institute of Bio- and Geosciences (IBG-1): Biotechnology, Forschungszentrum Jülich GmbH, Jülich, Germany
- Institute of Bioorganic Chemistry, Forschungszentrum Jülich, Heinrich Heine University Düsseldorf, Jülich, Germany
| | - M. Huang
- INRES, Molecular Phytomedicine, University of Bonn, Bonn, Germany
| | - R. Weihmann
- Institute of Molecular Enzyme Technology, Forschungszentrum Jülich, Heinrich Heine University Düsseldorf, Jülich, Germany
| | - X. Xiao
- INRES, Molecular Phytomedicine, University of Bonn, Bonn, Germany
| | - F. Gätgens
- Institute of Molecular Enzyme Technology, Forschungszentrum Jülich, Heinrich Heine University Düsseldorf, Jülich, Germany
| | - T. M. Weber
- Institute of Bioorganic Chemistry, Forschungszentrum Jülich, Heinrich Heine University Düsseldorf, Jülich, Germany
| | - H. U. C. Brass
- Institute of Bioorganic Chemistry, Forschungszentrum Jülich, Heinrich Heine University Düsseldorf, Jülich, Germany
| | - N. L. Bitzenhofer
- Institute of Molecular Enzyme Technology, Forschungszentrum Jülich, Heinrich Heine University Düsseldorf, Jülich, Germany
| | - S. Ibrahim
- Institute of Molecular Enzyme Technology, Forschungszentrum Jülich, Heinrich Heine University Düsseldorf, Jülich, Germany
| | - K. Bangert
- Institute of Molecular Enzyme Technology, Forschungszentrum Jülich, Heinrich Heine University Düsseldorf, Jülich, Germany
| | - L. Rehling
- INRES, Molecular Phytomedicine, University of Bonn, Bonn, Germany
| | - C. Mueller
- iAMB—Institute of Applied Microbiology, ABBt—Aachen Biology and Biotechnology, RWTH Aachen University, Aachen, Germany
| | - T. Tiso
- iAMB—Institute of Applied Microbiology, ABBt—Aachen Biology and Biotechnology, RWTH Aachen University, Aachen, Germany
| | - L. M. Blank
- iAMB—Institute of Applied Microbiology, ABBt—Aachen Biology and Biotechnology, RWTH Aachen University, Aachen, Germany
| | - T. Drepper
- Institute of Molecular Enzyme Technology, Forschungszentrum Jülich, Heinrich Heine University Düsseldorf, Jülich, Germany
| | - K.-E. Jaeger
- Institute of Bio- and Geosciences (IBG-1): Biotechnology, Forschungszentrum Jülich GmbH, Jülich, Germany
- Institute of Molecular Enzyme Technology, Forschungszentrum Jülich, Heinrich Heine University Düsseldorf, Jülich, Germany
| | | | - J. Pietruszka
- Institute of Bio- and Geosciences (IBG-1): Biotechnology, Forschungszentrum Jülich GmbH, Jülich, Germany
- Institute of Bioorganic Chemistry, Forschungszentrum Jülich, Heinrich Heine University Düsseldorf, Jülich, Germany
- *Correspondence: J. Pietruszka,
| | - A. S. S. Schleker
- INRES, Molecular Phytomedicine, University of Bonn, Bonn, Germany
- A. S. S. Schleker,
| | - A. Loeschcke
- Institute of Molecular Enzyme Technology, Forschungszentrum Jülich, Heinrich Heine University Düsseldorf, Jülich, Germany
- A. Loeschcke,
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Stern T, Roy A, Shapiro C, Harsh J, Ajayi A, Ibrahim S, Seiden D, Dubow J, Gudeman J. Long-Term Safety of Once-Nightly Sodium Oxybate: Interim Data From RESTORE. Sleep Med 2022. [DOI: 10.1016/j.sleep.2022.05.436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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14
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Chakraborty SR, Ibrahim S, Johari V, Hunt J, Freeman J. A Novel Fusion Partner in a Case of Myeloid/Lymphoid Neoplasm with FGFR1 Rearrangement. Am J Clin Pathol 2022. [DOI: 10.1093/ajcp/aqac126.227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Abstract
Introduction/Objective
Myeloid/lymphoid neoplasms with rearrangement of FGFR1 are uncommon and heterogeneous group of hematological malignancies that may present as myeloproliferative neoplasm, acute myeloid leukemia, T or B lymphoblastic lymphoma/leukemia, or mixed phenotypic acute leukemia. Patients can present with lymphadenopathy, mediastinal mass, or systemic symptoms. Eosinophilia is common in peripheral blood or bone marrow. Several chromosomal rearrangements and fusion genes have been described with FGFR1 rearrangement and all of them encode an aberrant tyrosine kinase. Tyrosine kinase inhibitors may offer a prospective therapeutic approach although specific targeted therapies have yet to be established.
Methods/Case Report
We present a case of a 14-year-old male who presented with rapid neck pain and swelling. Imaging revealed a 15 x 8 x 6 cm neck mass extending into the anterior mediastinum. Laboratory evaluation revealed anemia, thrombocytopenia, and leukocytosis (41.7 K/mm3), with absolute eosinophilia and blasts of 50%. Flow cytometry of peripheral blood demonstrated a population of T-lymphoblasts comprising about 60% of the cellularity with dim CD45, cytoplasmic CD3, CD7, TdT, CD38, CD4, CD5, CD10, and CD15, supporting T-lymphoblastic leukemia/lymphoma. The patient received induction chemotherapy, and subsequent bone marrow biopsy showed morphologic remission. Six weeks from diagnosis, the patient developed a gluteal mass with an atypical T-cell infiltrate that was negative for TdT; and at 15 weeks from diagnosis, developed an enlarging abdominal mass, also with an atypical T-cell infiltrate also negative for TdT and CD1a. At that time molecular diagnostic studies of the abdominal wall mass discovered a previously unpublished ATG16L1-FGFR1 fusion, supporting myeloid/lymphoid neoplasm with FGFR1 rearrangement, T-lymphoblastic leukemia/lymphoma.
Results (if a Case Study enter NA)
NA.
Conclusion
Although a variety of translocations have been identified with FGFR1 rearrangement, the novel fusion partner ATG16L1 has not been previously reported. The case also illustrates an unusual extramedullary recurrence of the T-cell lymphoblastic leukemia/lymphoma with significant antigenic shift including loss of TdT and CD1a.
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Affiliation(s)
- S R Chakraborty
- Pathology, UMass Chan Medical School - Baystate , West Hartford, Connecticut , United States
| | - S Ibrahim
- Pathology, UMass Chan Medical School - Baystate , West Hartford, Connecticut , United States
| | - V Johari
- Pathology, UMass Chan Medical School - Baystate , West Hartford, Connecticut , United States
| | - J Hunt
- Pathology, UMass Chan Medical School - Baystate , West Hartford, Connecticut , United States
| | - J Freeman
- Pathology, UMass Chan Medical School - Baystate , West Hartford, Connecticut , United States
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15
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Ibrahim S, Van Rooij J, Defesche J, Sedaghatikhayat B, Hovingh G, Uitterlinden A, Stroes E, Reeskamp L. Genetic testing for familial hypercholesterolemia using low-cost high-throughput microarray-based genotyping. Atherosclerosis 2022. [DOI: 10.1016/j.atherosclerosis.2022.06.225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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16
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Reeskamp L, Shim I, Dron J, Ibrahim S, Tromp T, Patel A, Hutten B, Stroes E, Hovingh G, Khera A. Polygenic risk for future coronary artery disease events in familial hypercholesterolemia. Atherosclerosis 2022. [DOI: 10.1016/j.atherosclerosis.2022.06.656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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17
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Perna S, Bahar K, Alalwan TA, Zahid MN, Gasparri C, Peroni G, Faragli A, La Porta E, Ali Redha A, Janahi EM, Ibrahim S, Rondanelli M. COVID-19 Knowledge, Attitudes, and Preventive Measures of University Students in Bahrain. Ann Ig 2022; 34:398-409. [PMID: 35700030 DOI: 10.7416/ai.2022.2507] [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] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
BACKGROUND The severe, acute respiratory syndrome COVID-19 that was first reported in China in December 2019 quickly became a global pandemic that has resulted in over 100 million infections and more than 2 million deaths. STUDY DESIGN This study aimed to assess the awareness level of university students regarding the possibility of becoming infected with COVID-19. In order to achieve this objective, we assessed the students' knowledge, attitudes, and behaviors using an online survey questionnaire offered to a total of 300 students. RESULTS A positive response regarding awareness of COVID-19 symptoms was registered by more than 70% of the students, whereas 62% felt that wearing a mask did not give full protection against infection, approximately 30% agreed that antibiotics and antivirals did not treat COVID-19, and 62% agreed that vitamin C was helpful in treating common symptoms of COVID-19. Moreover, around 31% of the students believed that COVID-19 is a man-made virus. Students who had gotten infected with SARS-CoV-2 believed that wearing a mask gives full protection (p=0.018). In response to survey questions related to attitude, 80% of students cancelled and postponed meetings with friends, and 90% agreed that mask-wearing is the most precautionary measure used to prevent the infection. In addition, 82% avoided coughing in public, 82% avoided contact if they felt flu-like symptoms and 80% washed their hands far more often due to the pandemic. Interestingly, 76% carried hand sanitizer, 66.5% avoided shaking hands, and 42.7% were taking vitamin C supplements. CONCLUSIONS This study showed that the participants had a positive awareness of COVID-19 transmission, symptoms, and treatments misconceptions and mistaken beliefs related to treatments and the origin of the virus were also common and should be addressed. This study thus provides a baseline for a population-based surveillance program that could help local authorities to improve pandemic preparation plans, particularly with regard to governmental education and media campaigns.
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Affiliation(s)
- S Perna
- Department of Biology, College of Science, University of Bahrain, Sakhir, Kingdom of Bahrain
| | - K Bahar
- Department of Biology, College of Science, University of Bahrain, Sakhir, Kingdom of Bahrain
| | - T A Alalwan
- Department of Biology, College of Science, University of Bahrain, Sakhir, Kingdom of Bahrain
| | - M N Zahid
- Department of Biology, College of Science, University of Bahrain, Sakhir, Kingdom of Bahrain
| | - C Gasparri
- Endocrinology and Nutrition Unit, Azienda di Servizi alla Persona ''Istituto Santa Margherita'', University of Pavia, Pavia, Italy
| | - G Peroni
- Endocrinology and Nutrition Unit, Azienda di Servizi alla Persona ''Istituto Santa Margherita'', University of Pavia, Pavia, Italy
| | - A Faragli
- Department of Internal Medicine/Cardiology, Deutsches Herzzentrum Berlin, Berlin, Germany
- Charité - Universitätsmedizin Berlin, Department of Internal Medicine and Cardiology, Campus Virchow-Klinikum, Berlin, Germany
- DZHK (German Centre for Cardiovascular Research), partner site Berlin, Germany
- Berlin Institute of Health (BIH), Berlin, Germany
| | - E La Porta
- Department of Cardionephrology, Istituto Clinico Ligure Di Alta Specialità (ICLAS), GVM Care and Research, Rapallo, Italy
- Department of Internal Medicine (DiMi), University of Genova, Genova, Italy
| | - A Ali Redha
- Department of Chemistry, College of Science, University of Bahrain, Sakhir, Kingdom of Bahrain
| | - E M Janahi
- Independent Virologist, Al Janabiyah, Northern Governorate, Kingdom of Bahrain
| | - S Ibrahim
- Food Microbiology and Biotechnology Laboratory, Department of Family and Consumer Sciences, College of Agriculture and Environmental Sciences, North Carolina A&T State University, Greensboro, NC, USA 12 IRCCS Mondino Foundation, Pavia, Italy
| | - M Rondanelli
- IRCCS Mondino Foundation, Pavia, Italy
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia, Italy
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18
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Sau A, Ibrahim S, Ahmed A, Handa B, Kramer DB, Waks JW, Arnold AD, Howard JP, Mandic D, Peters NS, Ng FS. Classification of organised atrial arrythmias using explainable artificial intelligence. Europace 2022. [DOI: 10.1093/europace/euac053.557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): BHF
NIHR
Background
Accurately determining atrial arrhythmia mechanisms from a 12-lead ECG can be challenging. Given the high success rate of cavotricuspid isthmus (CTI) ablation, accurate identification of CTI-dependent typical atrial flutter (AFL) is important for treatment decisions and procedure planning. Machine learning, with convolutional neural networks (CNNs) in particular, has been used to classify arrhythmias using the 12-lead ECG with great accuracy. However, most studies use human interpretation of the ECG as the ground truth to label the arrhythmia ECGs. Therefore, these neural networks can only ever be as good as expert human interpretation. We hypothesised a convolutional neural network could be trained to match or even exceed expert human performance in classifying CTI-dependent AFL vs. non-CTI dependent atrial tachycardia (AT), when using findings from the invasive electrophysiology (EP) study as the gold standard.
Methods
Figure 1 summarises the study methodology. We trained a CNN on data from 231 patients undergoing EP studies for atrial tachyarrhythmia. A total of 13500 5-second 12-lead ECG segments were used for training. Each case was labelled CTI-dependent AFL or non-CTI dependent AT based on the findings of the EP study. The model performance was evaluated against a test set of 57 patients. A survey of electrophysiologists and cardiologists in Europe was undertaken on the same 57 ECGs.
Results
The model had an accuracy of 86% (95% CI 0.77-0.95). The F1 score was 0.87.The AT/AFL network correctly identified AT 82% and AFL 90% of the time.
A saliency map can be used to help understand why a CNN predicted a particular outcome. This is achieved by mapping the outcome back to key areas of the input that most influenced the network in producing the classification result. Figure 2 presents the saliency mappings of an example 12-lead ECG for each class of AFL and AT. The network used the expected sections of the ECGs for diagnoses; these were the P-wave segments and not the QRS or other unexpected segments.
There were twelve respondents in the clinician survey. These respondents included nine electrophysiologists. The median accuracy was 78% (range 70-86%). The electrophysiologists had a median accuracy of 79%, (range 70-84%). Humans were more likely to incorrectly diagnose AFL as AT (on average incorrect diagnoses: 9 AFL, 1 AT). In comparison, the neural network most often incorrectly diagnosed AT as AFL (incorrect diagnoses: 5 AT, 3 AFL).
Conclusion
We describe the first neural network trained to differentiate CTI-dependent AFL from other atrial tachycardias. We found that our model surpassed expert human performance. Automated artificial intelligence enhanced ECG analysis could help guide treatment decisions and plan ablation procedures for patients with organised atrial arrhythmias.
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Affiliation(s)
- A Sau
- Imperial College London, London, United Kingdom of Great Britain & Northern Ireland
| | - S Ibrahim
- Imperial College London, London, United Kingdom of Great Britain & Northern Ireland
| | - A Ahmed
- Imperial College London, London, United Kingdom of Great Britain & Northern Ireland
| | - B Handa
- Imperial College London, London, United Kingdom of Great Britain & Northern Ireland
| | - DB Kramer
- Beth Israel Deaconess Medical Center & Harvard Medical School, Boston, United States of America
| | - JW Waks
- Beth Israel Deaconess Medical Center & Harvard Medical School, Boston, United States of America
| | - AD Arnold
- Imperial College London, London, United Kingdom of Great Britain & Northern Ireland
| | - JP Howard
- Imperial College London, London, United Kingdom of Great Britain & Northern Ireland
| | - D Mandic
- Imperial College London, London, United Kingdom of Great Britain & Northern Ireland
| | - NS Peters
- Imperial College London, London, United Kingdom of Great Britain & Northern Ireland
| | - FS Ng
- Imperial College London, London, United Kingdom of Great Britain & Northern Ireland
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19
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Ali MM, Baig MT, Huma A, Ibrahim S, Khan SA, Fatima R, Majeed S, Rawat A, Soomro H, Lodhi M, Jabeen A, Syed N, Huda A. Effect of Agaricus blazei Murill on exploratory behavior of mice-model. BRAZ J BIOL 2021; 84:e252575. [PMID: 34932635 DOI: 10.1590/1519-6984.252575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Accepted: 08/18/2021] [Indexed: 11/22/2022] Open
Abstract
Increased anxiety and depressive symptoms have reported to be its association with long term illness. Because of having unwanted effects of newly available drugs, patients administering anxiolytic drugs usually discontinue the treatment before they are completely recovered. Therefore, there is a serious need to develop new anxiolytic drugs. The anxiolytic effect of hydro-alcoholic extract of Agaricus blazei in animal models was assessed. 24 male mice (Mus musculus genus) were included in the study. Four groups were prepared and each group contained six animals. The groups were vehicle control, positive control (diazepam 1.0 mg/kg, i.p.) as well as two treatment groups receiving Agaricus blazei hydro-alcoholic extract at a dose of 136.50 mg/kg and 273.0 mg/kg orally. The Marble burying test, Nestlet shredding test and Light and Dark box test used to assess anxiolytic activity. Mice administered with diazepam 1.0 mg/kg, i.p. while hydro-alcoholic extract of AbM (136.50 and 273.0 mg/kg, respectively) was administered via oral route which exhibited marked reduction in number of marbles-burying as compared to vehicle control group. Mice administered with diazepam 1.0 mg/kg, i.p. and Oral administration of hydro-alcoholic extract of AbM (136.50 and 273.0 mg/kg, respectively) exhibited significant decrease in nestlet shredding in comparison to vehicle control group. The oral administration of hydro-alcoholic extract at a dose of 136.5mg/kg and 273mg/kg showed elevation in time spent in light box and was comparable to standard treated group while time spent by mice following oral administration of hydro-alcoholic extract of Agaricus blazei at a dose of 273.0 mg/kg also showed elevation and was found to be more near to standard treated group (diazepam 1 mg/kg, i.p.).
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Affiliation(s)
- M M Ali
- Ziauddin University, Faculty of Pharmacy, Department of Pharmaceutics, Karachi, Pakistan
| | - M T Baig
- Ziauddin University, Faculty of Pharmacy, Department of Pharmacy Practice, Karachi, Pakistan
| | - A Huma
- Ziauddin University, Faculty of Pharmacy, Department of Pharmacognosy, Karachi, Pakistan
| | - S Ibrahim
- Ziauddin University, Faculty of Pharmacy, Department of Pharmacology, Karachi, Pakistan
| | - S A Khan
- Memon Medical Institute Hospital, Karachi, Pakistan
| | - R Fatima
- Ziauddin University, Faculty of Pharmacy, Department of Pharmacy Practice, Karachi, Pakistan
| | - S Majeed
- Ziauddin University, Faculty of Pharmacy, Department of Pharmacology, Karachi, Pakistan
| | - A Rawat
- Ziauddin University, Faculty of Pharmacy, Department of Pharmacy Practice, Karachi, Pakistan
| | - H Soomro
- Ziauddin University, Faculty of Pharmacy, Department of Pharmaceutical Chemistry, Karachi, Pakistan
| | - M Lodhi
- Ziauddin University, Faculty of Pharmacy, Department of Pharmacology, Karachi, Pakistan
| | - A Jabeen
- Ziauddin University, Faculty of Pharmacy, Department of Pharmacology, Karachi, Pakistan
| | - N Syed
- Ziauddin University, Faculty of Pharmacy, Department of Pharmacy Practice, Karachi, Pakistan
| | - A Huda
- Sante Pharma (Pvt) Ltd, Karachi, Pakistan
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El-Faham A, Ibrahim S, Hemid A, Abd El-Azeem F, Mohamed M, Tammam A. CARCASS AND BONE CHARACTERISTICS OF BROILER CHICKENS FED DIFFERENT DIETARY FAT SOURCES. Egyptian Journal of Nutrition and Feeds 2021; 24:87-93. [DOI: 10.21608/ejnf.2021.210796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
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21
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Ghosh AK, Venkatraman S, Soroka O, Reshetnyak E, Rajan M, An A, Chae JK, Gonzalez C, Prince J, DiMaggio C, Ibrahim S, Safford MM, Hupert N. Association between overcrowded households, multigenerational households, and COVID-19: a cohort study. Public Health 2021; 198:273-279. [PMID: 34492508 PMCID: PMC8328572 DOI: 10.1016/j.puhe.2021.07.039] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [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: 04/06/2021] [Revised: 07/11/2021] [Accepted: 07/24/2021] [Indexed: 02/07/2023]
Abstract
OBJECTIVES The role of overcrowded and multigenerational households as a risk factor for COVID-19 remains unmeasured. The objective of this study is to examine and quantify the association between overcrowded and multigenerational households and COVID-19 in New York City (NYC). STUDY DESIGN Cohort study. METHODS We conducted a Bayesian ecological time series analysis at the ZIP Code Tabulation Area (ZCTA) level in NYC to assess whether ZCTAs with higher proportions of overcrowded (defined as the proportion of the estimated number of housing units with more than one occupant per room) and multigenerational households (defined as the estimated percentage of residences occupied by a grandparent and a grandchild less than 18 years of age) were independently associated with higher suspected COVID-19 case rates (from NYC Department of Health Syndromic Surveillance data for March 1 to 30, 2020). Our main measure was an adjusted incidence rate ratio (IRR) of suspected COVID-19 cases per 10,000 population. Our final model controlled for ZCTA-level sociodemographic factors (median income, poverty status, White race, essential workers), the prevalence of clinical conditions related to COVID-19 severity (obesity, hypertension, coronary heart disease, diabetes, asthma, smoking status, and chronic obstructive pulmonary disease), and spatial clustering. RESULTS 39,923 suspected COVID-19 cases were presented to emergency departments across 173 ZCTAs in NYC. Adjusted COVID-19 case rates increased by 67% (IRR 1.67, 95% CI = 1.12, 2.52) in ZCTAs in quartile four (versus one) for percent overcrowdedness and increased by 77% (IRR 1.77, 95% CI = 1.11, 2.79) in quartile four (versus one) for percent living in multigenerational housing. Interaction between both exposures was not significant (βinteraction = 0.99, 95% CI: 0.99-1.00). CONCLUSIONS Overcrowdedness and multigenerational housing are independent risk factors for suspected COVID-19. In the early phase of the surge in COVID cases, social distancing measures that increase house-bound populations may inadvertently but temporarily increase SARS-CoV-2 transmission risk and COVID-19 disease in these populations.
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Affiliation(s)
- A K Ghosh
- Department of Medicine, Weill Cornell Medical College, Cornell University, 525 E 68th St., New York, NY, 10065, USA.
| | - S Venkatraman
- Department of Statistics and Data Science, Cornell University, 129 Garden Ave., Ithaca, NY, 14853, USA
| | - O Soroka
- Department of Medicine, Weill Cornell Medical College, Cornell University, 525 E 68th St., New York, NY, 10065, USA
| | - E Reshetnyak
- Department of Medicine, Weill Cornell Medical College, Cornell University, 525 E 68th St., New York, NY, 10065, USA
| | - M Rajan
- Department of Medicine, Weill Cornell Medical College, Cornell University, 525 E 68th St., New York, NY, 10065, USA
| | - A An
- Department of Population Health Sciences, Weill Cornell Medical College, Cornell University, 402 E 67th St., New York, NY, 10065, USA
| | - J K Chae
- Department of Medicine, Weill Cornell Medical College, Cornell University, 525 E 68th St., New York, NY, 10065, USA
| | - C Gonzalez
- Department of Medicine, Weill Cornell Medical College, Cornell University, 525 E 68th St., New York, NY, 10065, USA
| | - J Prince
- Silberman School of Social Work at Hunter College, City University of New York, 2180 Third Ave, New York, NY, 10035, USA
| | - C DiMaggio
- Department of Surgery, New York University School of Medicine, 462 First Ave, NBV 15, New York, NY, 10016, USA
| | - S Ibrahim
- Department of Population Health Sciences, Weill Cornell Medical College, Cornell University, 402 E 67th St., New York, NY, 10065, USA
| | - M M Safford
- Department of Medicine, Weill Cornell Medical College, Cornell University, 525 E 68th St., New York, NY, 10065, USA
| | - N Hupert
- Department of Medicine, Weill Cornell Medical College, Cornell University, 525 E 68th St., New York, NY, 10065, USA; Department of Population Health Sciences, Weill Cornell Medical College, Cornell University, 402 E 67th St., New York, NY, 10065, USA
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Elshimy M, Ibrahim S, Malalasekera W. LES – DFSD modelling of vented hydrogen explosions in a small-scale combustion chamber. J Loss Prev Process Ind 2021. [DOI: 10.1016/j.jlp.2021.104580] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Mohamed-Zain NA, Jamil K, Penafort R, Singh A, Ibrahim S, Abdul-Rashid AH. Anxiety Reaction in Children During Cast Removal using Oscillating Saw versus Cast Shear - A Randomised, Prospective Trial. Malays Orthop J 2021; 15:122-128. [PMID: 34429832 PMCID: PMC8381665 DOI: 10.5704/moj.2107.018] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Accepted: 04/12/2021] [Indexed: 12/03/2022] Open
Abstract
Introduction: To compare the anxiety levels demonstrated by children during cast removal procedure between oscillating saw vs cast shear methods. Material and methods: A randomised prospective study of 102 children (mean age 8.3 ± 3.5 years) with fractures involving upper or lower limbs. Children undergoing removal of cast were divided into 2 groups; either by an oscillating saw or a cast cutting shear. The level of anxiety was assessed by recording the heart rate with a portable fingertip pulse oximeter before, during and after removal of the cast. Objective assessment was performed by documenting the fear level on Children’s Fear Scale (CFS). Results: There was a significant increase in the heart rate of children during cast removal while using the oscillating saw compared to cast shear (p<0.05). The noise level produced by the saw exceeded 80 dB (mean 103.3 dB). The fear level was significantly lower in the cast shear group (p<0.05). Conclusion: The noise produced by the oscillating saw was associated with an increased anxiety level in children undergoing cast removal. Cast shear is a simple and inexpensive instrument that can be used for cast removal in overly anxious children.
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Affiliation(s)
- N A Mohamed-Zain
- Department of Orthopaedics and Traumatology, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - K Jamil
- Department of Orthopaedics and Traumatology, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - R Penafort
- Department of Orthopaedics, KPJ Damansara Specialist Centre, Kuala Lumpur, Malaysia
| | - A Singh
- Department of Orthopaedics and Traumatology, Tengku Ampuan Rahimah Hospital, Klang, Malaysia
| | - S Ibrahim
- Department of Orthopaedics and Traumatology, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - A H Abdul-Rashid
- Department of Orthopaedics and Traumatology, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia.,Department of Orthopaedics, KPJ Damansara Specialist Centre, Kuala Lumpur, Malaysia.,Department of Orthopaedics and Traumatology, Tengku Ampuan Rahimah Hospital, Klang, Malaysia
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Jamil K, Yahaya MY, Abd-Rasid AF, Ibrahim S, Abdul-Rashid AH. Angular Deformities of the Knee in Children Treated with Guided Growth. Malays Orthop J 2021; 15:26-35. [PMID: 34429819 PMCID: PMC8381675 DOI: 10.5704/moj.2107.005] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Accepted: 04/05/2021] [Indexed: 11/21/2022] Open
Abstract
Introduction: The guided growth technique is an alternative to corrective osteotomy for treating angular deformities of the extremities. It has the advantage of being minimally invasive and is effective in a growing child. This study reports on the outcome of guided growth technique using a plate in correcting knee angular deformities. Material and Methods: We conducted a retrospective study of children with angular deformity of the knee treated by the guided growth technique from January 2010 to December 2015 in a tertiary centre. The guided growth technique was done using either the flexible titanium plate (8-plate) or the 2-hole reconstruction plate. Correction of deformity was assessed on radiographs by evaluating the mechanical axis deviation and tibiofemoral angle. The implants were removed once deformity correction was achieved. Results: A total of 17 patients (27 knees) were evaluated. Twenty-two knees (81.5%) achieved complete correction of the deformity. The median age was 4.0 (interquartile range 3.0-6.0) years and the median Body Mass Index (BMI) was 26.0 (25.0-28.0). There were 7 unilateral and 10 bilateral deformities with different pathologies (14 tibia vara, 3 genu valgus). The median rate of correction was 0.71° per month. One patient (1 knee) had screw pull-out and two patients (4 knees) had broken screws in the proximal tibia. Three patients (5 knees) failed to achieve complete correction and were subsequently treated with corrective osteotomies. Out of five patients (8 knees) who were followed-up for at least 12 months after removal of hardware, two had rebound deformities. No permanent growth retardation occurred in our patients. Conclusion: Our outcome for guided growth to correct knee angular deformity was similar to other studies. Guided growth is safe to perform in children below 12 years old and has good outcome in idiopathic genu valgus and Langeskiold II for tibia vara. Patients should be observed for recurrence until skeletal maturity following implant removal.
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Affiliation(s)
- K Jamil
- Department of Orthopaedics and Traumatology, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - M Y Yahaya
- Department of Orthopaedics, Universiti Teknologi Mara, Batu Caves, Malaysia.,Faculty of Medicine, Universiti Teknologi Mara, Sungai Buloh, Malaysia
| | - A F Abd-Rasid
- Department of Orthopaedics and Traumatology, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - S Ibrahim
- Department of Orthopaedics and Traumatology, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - A H Abdul-Rashid
- Department of Orthopaedics and Traumatology, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
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Fayad MM, Mohamed DE, Soliman E, El-Fattah MA, Ibrahim S, Dardir M. Optimization of invert emulsion oil-based drilling fluids performance through heterocyclic imidazoline-based emulsifiers. Colloids Surf A Physicochem Eng Asp 2021. [DOI: 10.1016/j.colsurfa.2020.126092] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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26
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Hayyun MF, Jamil K, Abd-Rashid AH, Ibrahim S. Subcapital Femoral Neck Tension Stress Fracture - A Rare Injury in A Child: A Case Report. Malays Orthop J 2021; 15:132-134. [PMID: 33880161 PMCID: PMC8043632 DOI: 10.5704/moj.2103.021] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Femoral neck stress fractures are rare in children. To the best of our knowledge, the tension type stress fracture has been reported only twice in the English language literature. We report on a five years follow-up of a 10-year-old boy with this injury which was initially missed. The fracture healed after screw fixation. We highlight the importance of considering stress fracture as a differential diagnosis in a child with chronic hip pain. A careful physical examination and the appropriate imaging will avoid missing the diagnosis.
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Affiliation(s)
- M F Hayyun
- Department of Orthopaedics and Traumatology, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - K Jamil
- Department of Orthopaedics and Traumatology, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - A H Abd-Rashid
- Department of Orthopaedics and Traumatology, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - S Ibrahim
- Department of Orthopaedics and Traumatology, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
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Sani A, Abdullahi I, Ibrahim S. Histopathological changes associated with exposure to metal welding fumes in some organs of Rattus norvegicus in Kano, Nigeria. Toxicol Rep 2021; 8:422-428. [PMID: 33680865 PMCID: PMC7930506 DOI: 10.1016/j.toxrep.2021.02.016] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [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: 01/17/2020] [Revised: 02/08/2021] [Accepted: 02/20/2021] [Indexed: 11/17/2022] Open
Abstract
Welding fumes has been known to cause release of reactive oxygen species which stands to be cytotoxic. The study aims to assess the histopathological changes of some organs associated with exposure to welding fumes in experimental animals. The metal fumes were obtained from sites of welding. A total of 130 male albino rats were engaged and divided into a 13 groups. Out of which 12 were given respective doses calculated to be equivalent to worker's real life exposure times and 1 as control. The doses were intratracheally administered weekly following anesthetization for a period of 12 weeks. The laboratory rats were then sacrificed and target organs were examined. Histopathological examination reveals normal feature for brain tissues in all treated animals. However, there was lymphocyte hyperplasia and necrosis in heart, kidney, liver and lungs tissues which at lower doses were slight and became moderate at higher doses. In addition, there were'nt pathological changes in tissues of the control animals. Thus, exposure to metal welding fumes has caused damages that have translated into lesions and several pathologies in kidney, lungs, liver and heart tissues of the test animals. Regulation and control should be imposed on exposure to welding fumes by metal workers.
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Affiliation(s)
- A. Sani
- Department of Instrument Science and Engineering, School of Electronic, Information and Electrical Engineering, Shanghai Jiao Tong University, Shanghai, 200240, China
- Department of Biological Sciences, Bayero University Kano, P.M.B. 3011, Kano, Nigeria
| | - I.L. Abdullahi
- Department of Biological Sciences, Bayero University Kano, P.M.B. 3011, Kano, Nigeria
| | - S. Ibrahim
- Department of Biological Sciences, Bayero University Kano, P.M.B. 3011, Kano, Nigeria
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Saba S, Al Sergani A, Vriz O, Kholaif N, Ramzan K, Jawad Shah S, Ahmad O, Albayyat R, Di Michele S, Pergola V, Di Giannuario G, Elmahi I, Ibrahim S, Galzerano D, Di Salvo G. Echocardiographic features and behavior of cardiac structural abnormalities in mucopolysaccharidosis. Eur Heart J Cardiovasc Imaging 2021. [DOI: 10.1093/ehjci/jeaa356.086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Mucopolysaccharidosis (MPS) is a rare genetic lysosomal storage disorder with a wide variability of phenotype. A systematic descriptive study dealing with the echocardiographic (E) features of valvular involvement and their evolution over the time in adolescent and adult patients, whose number is growing up in adult echocardiographic laboratory, is lacking in the medical literature.
Purpose
To detect the E features of valvular involvement and their evolution in adolescent and adult patients.
Method
Study design: observational descriptive retrospective. Study group: 142 E studies in 17 adolescent and adult patients with diagnosis of MPS from 2001 until 2020. Mitral (M), aortic (A), tricuspid (T) valves (V) E features (thickness, mobility, calcification, and function), their evolution over the time and the behaviour with Enzyme replacement therapy (ERT) or bone marrow transplant (BMT) were assessed.
Result
52% male, mean age 21 yrs ranges 16 to 48 yrs. 5% of the patient had MPS type I, 11% MPS type II, 29% MPS type IV, and 52% MPS type VI. 70% received ERT and 11% BMT.
In the severe case all the valves were involved (panel A, B, C; white arrows point to valve leaflets; yellow arrows MV apparatus) the whole MV apparatus was involved since the earlier stage and in the latest stage the calcification was massive (panel C). The predominant valvular dysfunction was the regurgitation followed by mixed disorder while the most frequent severe lesion was the stenosis; the echocardiographic pattern differs from the classical hockey stick appearance of the early phase of rheumatic MV and the thickening is different from the myxomatous MV for the reduced mobility and the presence of calcification. The reduced mobility of the TV (panel C) also differs from the Loeffler syndrome because of the restriction of the leaflets and the association with thickening and calcification. Under treatment, the MV thickening was found to have a slow progression of less than 1 mm yearly in 61% cases.
Conclusion
Our results showed that all the valves are affected mainly the MV; the echocardiographic pattern of MPS, different from other valvular diseases of adolescent and adult age, can help in avoiding misdiagnose. Our observations also suggest that the cardiac involvement show slow rate of progression after the initiation of the therapy. Further studies are required to confirm our results.
Type of valve % of valve thickness % of reduced mobility % calcification diffuse % valve lesion Mitral valve 88% 65% 47% 75% Aortic valve 76% 23% 41% 57% Tricuspid valve 82% 47% 17% 52% Abstract Figure. Echocardiographic features
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Affiliation(s)
- S Saba
- King Faisal Specialist Hospital & Research Centre, Heart Centre, Riyadh, Saudi Arabia
| | - A Al Sergani
- King Saud University, College of Medicine, Riyadh, Saudi Arabia
| | - O Vriz
- King Faisal Specialist Hospital & Research Centre, Heart Centre, College of Medicine, Alfaisal University, Riyadh, Saudi Arabia
| | - N Kholaif
- King Faisal Specialist Hospital & Research Centre, Heart Centre, College of Medicine, Alfaisal University, Riyadh, Saudi Arabia
| | - K Ramzan
- King Faisal Specialist Hospital & Research Centre, Department of Genetics, and Research Centre, Riyadh, Saudi Arabia
| | - S Jawad Shah
- King Faisal Specialist Hospital & Research Centre, Oncology and General surgery, Riyadh, Saudi Arabia
| | - O Ahmad
- King Faisal Specialist Hospital & Research Centre, Heart Centre, Riyadh, Saudi Arabia
| | - R Albayyat
- King Faisal Specialist Hospital & Research Centre, Heart Centre, Riyadh, Saudi Arabia
| | - S Di Michele
- San Filippo Neri Hospital, Cardiology Division , Rome, Italy
| | - V Pergola
- University of Padua, Department of Cardio-Thoraco-Vascular Sciences and Public Health, Padua, Italy
| | - G Di Giannuario
- Infermi Hospital of Rimini, Cardiology Division, Rimini, Italy
| | - I Elmahi
- Alfaisal University, College of Medicine, Riyadh, Saudi Arabia
| | - S Ibrahim
- King Faisal Specialist Hospital & Research Centre, Heart Centre, Riyadh, Saudi Arabia
| | - D Galzerano
- King Faisal Specialist Hospital & Research Centre, Heart Centre, College of Medicine, Alfaisal University, Riyadh, Saudi Arabia
| | - G Di Salvo
- University of Padua, Paediatric Cardiology and Congenital Heart Disease Department, padua, Italy
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Danbirni S, Kaltungo BY, Daudu BB, Mohammed FU, Abubakar UB, Ibrahim S, Usman A, Sackey AKB. Clinical management protocol of an acute contagious bovine pleuropnuemonia in a 6- year-old Bunaji cow in Sakaru village of Soba local government area, Kaduna state, Nigeria. ACTA ACUST UNITED AC 2020. [DOI: 10.51791/njap.v47i2.98] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
The test and slaughter policy of the federal government of Nigeria on contagious bovine pleuropneumonia (CBPP) in cattle is no longer feasible because it lacked the political will as a result, farmers tend to treat their cattle of the disease most which has been ineffective. herefore, the quest for a supportive clinical management protocol for CBPP in cattle aimed at enabling the cow regain its body condition in order to allow the farmer sell the cow for slaughter at a profit was the aim of this case report. A 6-year-old Bunaji cow weighing 350kg with history of not feeding well, lagging behind during grazing, difficulty in breathing, intermittent cough and bloat was presented. Physical examination was carried out and differential diagnoses which included contagious bovine pleuropneumonia, mango choke, Pasteurellosis and tuberculosis were considered. After a careful scrutiny of the differentials, a tentative diagnosis of contagious bovine pleuropneumonia which was confirmed by the Latex agglutination test (LAT) was arrived at. A supportive clinical management protocol was instituted with the sole aim of enabling the cow regain its body condition in order to allow the farmer sell the cow for slaughter at a profit. The protocol involved isolation of the cow and administration of 20% tetracycline long acting through a combination of conventional (intra-muscular) and non-conventional (intra-venous) routes of administration along with an anti-inflammatory agent and an appetite stimulant. Six days after the commencement of therapy, the observed clinical signs subsided greatly and the cow became apparently healthy. The study showed that, the protocol of administering 20%tetracycline long acting through a combination of conventional (intra-muscular) and nonconventional (intra-venous) routes along with an anti-inflammatory agent (dexamethasone) and an appetite stimulant (vit. B. complex) was effective and profitable to the farmer. The client was advised to sell the cow for slaughter after observing the 21- day withdrawal period of the drugs.
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Shamah A, Ibrahim S, Hanna F, Abbas Y, Abd-ELaziz MM. Investigation of Quasicrystalline Phases Formation by mechanical Alloying of the Al - Cr and Al - Fe Alloys (Dept.P). MEJ Mansoura Engineering Journal 2020; 32:25-31. [DOI: 10.21608/bfemu.2020.128596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
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Abstract
Predatory journals and conferences have little or no peer review. Their raison d'être is for making money through the article processing charges and the conference registration fees. Without a critical evaluation, predatory journals publishing flawed results and conclusions would cloud the existing scientific literature. Predatory conferences are the offshoots of predatory publishing. The conferences are not organised by learned societies, but by profit-making event organisers. There is a need for awareness among researchers and clinicians regarding predatory publishing. The scourge of predatory publishing and conferencing should be more often highlighted during scientific meetings and publication courses.
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Affiliation(s)
- S Ibrahim
- Department of Orthopaedics and Traumatology, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia
| | - A Saw
- Department of Orthopaedic Surgery (NOCERAL), University Malaya Medical Centre, Kuala Lumpur, Malaysia
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Hisham A, Md Mydin Siddik N, Ibrahim S, Mohd Yussof SJ. Letter to the editor regarding the article, "young lady with bilateral yellowish lesions on her eyelids". Malays Fam Physician 2020; 15:56-57. [PMID: 32843948 PMCID: PMC7430312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Affiliation(s)
- A Hisham
- MRCSEd, MS Plastic Surgery (USM) Faculty of Medicine, Universiti Teknologi MARA, Cawangan Selangor, Kampus Sungai Buloh Jalan Hospital, 47000, Selangor Malaysia
| | - Nsf Md Mydin Siddik
- MS Plastic Surgery (USM) Faculty of Medicine, Universiti Teknologi MARA, Cawangan Selangor, Kampus Sungai Buloh Jalan Hospital, 47000, Selangor, Malaysia
| | - S Ibrahim
- MD (UKM), FRCS (Edinburgh) Department of Plastic and Reconstructive Surgery, Hospital Sungai Buloh, Selangor, Malaysia
| | - S J Mohd Yussof
- MRCS (Ire), MS Plastic Surgery (USM) Faculty of Medicine, Universiti Teknologi MARA, Cawangan Selangor, Kampus Sungai Buloh Jalan Hospital, 47000, Selangor, Malaysia
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Mehta B, Ho K, Bido J, Parks M, Russell L, Goodman S, Ibrahim S. FRI0379 VARIATIONS IN THE UTILIZATION OF BILATERAL TOTAL KNEE ARTHROPLASTY IN THE MANAGEMENT OF OSTEOARTHRITIS. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.5896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:A third of knee osteoarthritis presents with bilateral symptomatic arthritis. In these patients, treatment options include either a staged Unilateral Total knee arthroplasty (UTKA) procedure, or a simultaneous Bilateral TKA (BTKA) procedure. Even though literature regarding outcomes in BTKA procedure has not consistently been favorable, it remains popular in select patients due to use of a single anesthetic, shorter overall surgical time, lower cost and lower overall use of narcotics. African Americans (AAs) have lower utilization and worse outcomes in UTKA literature. It is unclear whether these racial variations extend to BTKA.Objectives:We sought to examine BTKA vs UTKA utilization rates and outcomes comparing AA and White patients.Methods:National Inpatient Sample (NIS) - Healthcare Cost and Utilization Project (HCUP) database (2007-2016) was used. We identified all patients ≥ 50 years who underwent elective primary TKA using ICD-9-CM code 81.54 for UTKA and BTKA from January 1, 2012 to September 30, 2015, and ICD-10-CM codes 0SRC0x and 0SRD0x thereafter. Patients with inflammatory arthritis, pathologic fractures, metastatic disease and avascular necrosis were excluded. Major in-hospital complications included post-operative myocardial infarction, prosthetic device complication, surgical wound infection, and venous thromboembolism. Differences in temporal trends in utilization and major in-hospital complications of BTKA vs UTKA were compared between AAs and Whites. Multivariable logistic regression models were used to assess differences in both these trends between AAs and Whites after adjusting for individual (age, sex, Elixhauser comorbidity index, and morbid obesity), hospital level (hospital volume, bed size, region and teaching status) and community level (median household income) variables. Discharge weights were used to enable nationwide estimates. Multiple imputation was performed for missing race variable (11.9%).Results:From 2007 to 2016, an estimated 276,194 BTKA (unweighted observations 56,675) and 5,528,429 UTKA (unweighted observations 1,131,329) were identified (Table 1). Females had a higher proportion of TKAs performed (62.1% UTKA vs 55.9% BTKA). Patients had fewer comorbidities (measured by the Elixhauser Index) when undergoing BTKA compared to UTKA. The proportion of BTKA amongst all TKAs declined from 5.53% in 2007-08 to 4.03% in 2015-16. AAs continued to have significantly lower proportion of BTKA utilization compared to Whites (4.68% in AAs vs 6.08% in Whites in 2007-08, whereas 3.28% in AAs vs 4.19% in Whites in 2015-16, adjusted p < 0.001) (Figure 1a). In-hospital complication rates for UTKA and BTKA were significantly higher in Whites compared to AAs throughout the study period (0.77% in AAs vs 0.9% in Whites in 2007-08, whereas 0.69% in AAs vs 0.83% in Whites in 2015-16, adjusted p < 0.001) (Figure 1b). The results were similar after imputation of missing race values.Conclusion:In this nationwide sample of patients from 2007 to 2016, we found that AAs have lower utilization rate of BKTA compared to Whites, however the in-hospital complication rates were significantly higher in Whites.References:N/ATable 1.Weighted frequencies and percentages of demographic characteristics among unilateral TKA vs. bilateral TKA (N = 6, 236, 426).VariableUnilateral TKABilateral TKAPaN = 5,528,429(Unweighted N = 1,131,329)N = 276,194(Unweighted N = 56,675)Patient CharacteristicsAge, mean (SD)67.4 (0.02)65.0 (0.06)<.0001Sex: Female, n(%)3,429,484 (62.1)154,442 (55.9)<.0001Race, n(%): White4,051,648 (50.9)212,468 (76.9)<.0001 African American352,933 (6.4)14,441 (5.2) Other464,407 (8.4)16,443 (6.0) Missing659,439 (11.9)32,842 (11.9)Morbid Obesity, n(%)401,892 (7.3)20,411 (7.4)0.47Elixhauser Indexd, n(%):<.0001 0716,559 (13.0)41,550 (15.0) 1-44,484,941 (81.1)220,638 (80.0) ≥ 5326,928 (5.9)14,007 (5.1)Disclosure of Interests:Bella Mehta: None declared, Kaylee Ho: None declared, Jennifer Bido: None declared, Michael Parks Consultant of: Zimmer Biomet, Linda Russell: None declared, Susan Goodman Shareholder of: Reginosine- Investment, Grant/research support from: Novartis, Horizon, Consultant of: Novartis, Celgene, UCB, Said Ibrahim: None declared
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Ibrahim S, Wharton R, Harmon E, Bonner H, Davis E, Cho Y, Mazimba S, Kwon Y. 0622 In-Depth Surveillance of Central Sleep Apnea in Patients with Stable Heart Failure. Sleep 2020. [DOI: 10.1093/sleep/zsaa056.619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Introduction
Central sleep apnea (CSA) is unique sleep breathing phenotype in patients with advanced chronic heart failure (HF) and portend poor prognosis. The prevalence of CSA in HF patients under contemporary therapy is uncertain.
Methods
We reviewed consecutive HF patients on optimal medical therapy who underwent clinically indicated diagnostic in-lab polysomnography at a single academic center. Age, sex and BMI matched patients without HF were selected from sleep clinic as a control. Patients with atrial fibrillation were excluded from this study. Apnea subtypes were determined after careful scoring and confirmation by sleep physicians. ‘Any CSA’ was defined by central apnea index (CAI) >5 and >1/hr. ‘True CSA’ was defined if met both CAI≥5/hr and > obstructive apnea index (OAI). Obstructive sleep apnea (OSA) was defined if apnea hypopnea index >15 and OAI>CAI. Multivariate analysis was performed using logistic regression adjusting for age, sex, HF and systolic dysfunction as appropriate.
Results
In patients with HF (N=95, mean age 59, female: 50%), CSA was low and was comparable to control group (N=94) (HF vs. Non-HF; CSA: 5.3 vs. 4.3%, P=NS; Any CSA 14.7 vs. 17%, P=NS). Only 3 patients with HF had true CSA. In contrast, OSA was common in both groups regardless of obesity status (52.3 vs. 55.3%). In patients with HF, Cheyne Stokes respiration was more frequent in patients with Any CSA vs. without Any CSA (13.3 vs. 3.8%, p=0.04). In multivariate analysis, presence of OSA, but not HF, was associated with Any CSA in entire cohort (Any CSA OR: 3.1 [1.3, 8.1], p=0.02). In patients with HF, male sex was associated with Any CSA (OR: 5.3 [1.1, 40.8], p=0.05). Exclusion of patients with high BMI did not change the results.
Conclusion
CSA was rare in patients with stable HF on contemporary optimal medical therapy.
Support
None
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Affiliation(s)
- S Ibrahim
- University of Virginia, Charlottesville, VA
| | - R Wharton
- University of Virginia, Charlottesville, VA
| | - E Harmon
- University of Virginia, Charlottesville, VA
| | - H Bonner
- University of Virginia, Charlottesville, VA
| | - E Davis
- University of Virginia, Charlottesville, VA
| | - Y Cho
- University of Virginia, Charlottesville, VA
| | - S Mazimba
- University of Virginia, Charlottesville, VA
| | - Y Kwon
- University of Virginia, Charlottesville, VA
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Arafat MM, Rozali S, Haseeb ASMA, Ibrahim S. Direct and catalyst-free synthesis of ZnO nanowires on brass by thermal oxidation. Nanotechnology 2020; 31:175603. [PMID: 31918416 DOI: 10.1088/1361-6528/ab69b3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
In this research work, nanowires were grown on brass (Cu - 37.2 wt% Zn) substrate by thermal oxidation. The substrate was oxidized at temperatures ranging from 350 °C to 600 °C in the presence of varying concentrations of O2 (1%-100%) in N2 flown at a rate of 200 sccm. The oxidized brass surface was characterized by field emission scanning electron microscope equipped with energy dispersive x-ray spectroscope and transmission electron microscope. Four different types of morphological variations such as thin, thick with branches, circular-flake and flat-cone shape nanostructures were observed during oxidation at different conditions. However, the prevalence of thin and thick morphology with branches was more prominent and found in all growth conditions. The length and diameter of the nanowires varied from 1 to 30 μm and 50 to 500 nm, respectively, whereas the length of the branches varied from 1 to 3 μm. The composition of the nanowires was ZnO possessing of hexagonal wurtzite structure. The selected area diffraction confirms that the nanowires grew along 〈1 1 [Formula: see text] 0〉 directions. Based on the results, a stress induced mechanism is proposed for the growth of ZnO nanowires on Cu - 37.2 wt% Zn substrate.
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Ibrahim S, Zulkharnain A, Zahri KNM, Lee G, Convey P, Gomez-Fuentes C, Sabri S, Khalil KA, Alias SA, Gonzalez-Rocha G, Ahmad SA. Effect of heavy metals and other xenobiotics on biodegradation of waste canola oil by cold-adapted Rhodococcus sp. strain AQ5-07. Rev Mex Ing Quim 2020. [DOI: 10.24275/rmiq/bio917] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Said M, adam A, Ibrahim S, Gawish R, Lewis N. SUN-237 HCV INFECTION IS PROTECTIVE AGAINST OXIDATIVE STRESS IN ESRD PATIENTS ON MAINTENANCE HEMODIALYSIS. Kidney Int Rep 2020. [DOI: 10.1016/j.ekir.2020.02.772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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Anemüller W, Busch H, Fleischer M, Hundt JE, Ibrahim S, Kahle B, Ludwig RJ, Recke A, Recke AL, Rose E, Sadik CD, Schmidt E, Schumacher N, Thaçi D, Terheyden P, Wolff HH, Zillikens D. Klinik für Dermatologie, Allergologie und Venerologie der Universität zu Lübeck: Interaktion von Forschung und klinischer Versorgung. Akt Dermatol 2020. [DOI: 10.1055/a-1066-5392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
ZusammenfassungDie Ursprünge der Lübecker Universitäts-Hautklinik reichen in die 30er-Jahre des letzten Jahrhunderts zurück. Die Klinik hat in den letzten Jahrzehnten eine konsequente bauliche und inhaltliche Weiterentwicklung erfahren und verfügt heute über 85 Betten auf 2 Stationen und in einer Tagesklinik. Ein modernes Weiterbildungsprogramm, das auf einem Rotationsprinzip durch 5 verschiedene stationäre und ambulante Teams beruht, vermittelt alle wesentlichen Lerninhalte der Dermatologie. Die Erweiterung der Klinik in den letzten Jahren beruhte auf einer engen Interaktion von Grundlagenforschung und klinischer Tätigkeit, insbesondere auf dem Gebiet kutaner Autoimmunerkrankungen und entzündlicher Dermatosen. Die wissenschaftliche Entwicklung der Hautklinik profitierte seit 2007 insbesondere von der Förderung durch die Exzellenzinitiative des Bundes (Exzellenzcluster Inflammation at Interfaces). Daneben wurde durch die Deutsche Forschungsgemeinschaft (DFG) seit 2011 unter Federführung der Hautklinik ein Graduiertenkolleg Modulation of Autoimmunity gefördert, das zur Entwicklung des wissenschaftlichen Nachwuchses und zur Ausbildung zahlreicher naturwissenschaftlicher und medizinischer Doktoranden/Doktorandinnen1 beitrug. Seit 2015 besteht an der Klinik auch eine Klinische Forschungsgruppe der DFG zum Thema Pemphigoid Diseases – Molecular Pathways and their Therapeutic Potential. Im Jahr 2018 haben Mitarbeiter der Klinik wesentlich zur Einwerbung eines Clinician Scientist-Programms der DFG beigetragen, das die wissenschaftliche Ausbildung forschender Kliniker verbessern soll. In den letzten Jahren haben sich aus der Lübecker Hautklinik heraus 2 eigenständige Institute neu etabliert. Hierzu zählen das Institut für Entzündungsmedizin unter der Leitung von Prof. Diamant Thaçi, in dem klinische Studien zu entzündlichen Hauterkrankungen initiiert und koordiniert werden und die Versorgung von Patienten mit entzündlichen Dermatosen stattfindet. Daneben ist aus der Hautklinik heraus das Lübecker Institut für Experimentelle Dermatologie (LIED) entstanden, in dem derzeit 5 Professoren mit ihren jeweiligen Arbeitsgruppen zu unterschiedlichen Themen der Entzündung an der Haut forschen. Die interdisziplinären wissenschaftlichen Aktivitäten zur Entzündung an der Haut am Lübecker Campus werden seit 2015 in einem Center for Research on Inflammation of the Skin (CRIS) gebündelt. CRIS erhielt kürzlich die Zusage für ein eigenständiges Forschungsgebäude, das nach § 91 Grundgesetz durch Bund und Land finanziert wird und derzeit im Zentrum des Lübecker Campus entsteht. Der Ausbau der Forschungsstrukturen der Klinik ging mit der Einrichtung von Spezialambulanzen für verschiedene entzündliche Hauterkrankungen, aber auch für die Versorgung von Hautkrebs und chronischen Wunden einher. Die Klinik verfügt über ein zertifiziertes Hautkrebszentrum und ist Teil der Lübecker universitären Gefäß- und Krebszentren. Weitere wichtige Pfeiler der klinischen Versorgung sind zertifizierte diagnostische Einsendelabore für Dermato-Histopathologie und kutane Autoimmunerkrankungen.
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Affiliation(s)
- W. Anemüller
- Klinik für Dermatologie, Allergologie und Venerologie, Universitätsklinikum Schleswig-Holstein, Campus Lübeck
| | - H. Busch
- Klinik für Dermatologie, Allergologie und Venerologie, Universitätsklinikum Schleswig-Holstein, Campus Lübeck
| | - M. Fleischer
- Klinik für Dermatologie, Allergologie und Venerologie, Universitätsklinikum Schleswig-Holstein, Campus Lübeck
| | - J. E. Hundt
- Klinik für Dermatologie, Allergologie und Venerologie, Universitätsklinikum Schleswig-Holstein, Campus Lübeck
| | - S. Ibrahim
- Klinik für Dermatologie, Allergologie und Venerologie, Universitätsklinikum Schleswig-Holstein, Campus Lübeck
| | - B. Kahle
- Klinik für Dermatologie, Allergologie und Venerologie, Universitätsklinikum Schleswig-Holstein, Campus Lübeck
| | - R. J. Ludwig
- Klinik für Dermatologie, Allergologie und Venerologie, Universitätsklinikum Schleswig-Holstein, Campus Lübeck
| | - A. Recke
- Klinik für Dermatologie, Allergologie und Venerologie, Universitätsklinikum Schleswig-Holstein, Campus Lübeck
| | - A. L. Recke
- Klinik für Dermatologie, Allergologie und Venerologie, Universitätsklinikum Schleswig-Holstein, Campus Lübeck
| | - E. Rose
- Klinik für Dermatologie, Allergologie und Venerologie, Universitätsklinikum Schleswig-Holstein, Campus Lübeck
| | - C. D. Sadik
- Klinik für Dermatologie, Allergologie und Venerologie, Universitätsklinikum Schleswig-Holstein, Campus Lübeck
| | - E. Schmidt
- Klinik für Dermatologie, Allergologie und Venerologie, Universitätsklinikum Schleswig-Holstein, Campus Lübeck
| | - N. Schumacher
- Klinik für Dermatologie, Allergologie und Venerologie, Universitätsklinikum Schleswig-Holstein, Campus Lübeck
| | - D. Thaçi
- Klinik für Dermatologie, Allergologie und Venerologie, Universitätsklinikum Schleswig-Holstein, Campus Lübeck
| | - P. Terheyden
- Klinik für Dermatologie, Allergologie und Venerologie, Universitätsklinikum Schleswig-Holstein, Campus Lübeck
| | - H. H. Wolff
- Klinik für Dermatologie, Allergologie und Venerologie, Universitätsklinikum Schleswig-Holstein, Campus Lübeck
| | - D. Zillikens
- Klinik für Dermatologie, Allergologie und Venerologie, Universitätsklinikum Schleswig-Holstein, Campus Lübeck
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Elisofon SA, Magee JC, Ng VL, Horslen SP, Fioravanti V, Economides J, Erinjeri J, Anand R, Mazariegos GV, Martin A, Mannino D, Flynn L, Mohammad S, Alonso E, Superina R, Brandt K, Riordan M, Lokar J, Ito J, Elisofon S, Zapata L, Jain A, Foristal E, Gupta N, Whitlow C, Naik K, Espinosa H, Miethke A, Hawkins A, Hardy J, Engels E, Schreibeis A, Ovchinsky N, Kogan‐Liberman D, Cunningham R, Malik P, Sundaram S, Feldman A, Garcia B, Yanni G, Kohli R, Emamaullee J, Secules C, Magee J, Lopez J, Bilhartz J, Hollenbeck J, Shaw B, Bartow C, Forest S, Rand E, Byrne A, Linguiti I, Wann L, Seidman C, Mazariegos G, Soltys K, Squires J, Kepler A, Vitola B, Telega G, Lerret S, Desai D, Moghe J, Cutright L, Daniel J, Andrews W, Fioravanti V, Slowik V, Cisneros R, Faseler M, Hufferd M, Kelly B, Sudan D, Mavis A, Moats L, Swan‐Nesbit S, Yazigi N, Buranych A, Hobby A, Rao G, Maccaby B, Gopalareddy V, Boulware M, Ibrahim S, El Youssef M, Furuya K, Schatz A, Weckwerth J, Lovejoy C, Kasi N, Nadig S, Law M, Arnon R, Chu J, Bucuvalas J, Czurda M, Secheli B, Almy C, Haydel B, Lobritto S, Emand J, Biney‐Amissah E, Gamino D, Gomez A, Himes R, Seal J, Stewart S, Bergeron J, Truxillo A, Lebel S, Davidson H, Book L, Ramstack D, Riley A, Jennings C, Horslen S, Hsu E, Wallace K, Turmelle Y, Nadler M, Postma S, Miloh T, Economides J, Timmons K, Ng V, Subramonian A, Dharmaraj B, McDiarmid S, Feist S, Rhee S, Perito E, Gallagher L, Smith K, Ebel N, Zerofsky M, Nogueira J, Greer R, Gilmour S, Robert C, Cars C, Azzam R, Boone P, Garbarino N, Lalonde M, Kerkar N, Dokus K, Helbig K, Grizzanti M, Tomiyama K, Cocking J, Alexopoulos S, Bhave C, Schillo R, Bailey A, Dulek D, Ramsey L, Ekong U, Valentino P, Hettiarachchi D, Tomlin R. Society of pediatric liver transplantation: Current registry status 2011-2018. Pediatr Transplant 2020; 24:e13605. [PMID: 31680409 DOI: 10.1111/petr.13605] [Citation(s) in RCA: 62] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Revised: 08/08/2019] [Accepted: 09/27/2019] [Indexed: 11/29/2022]
Abstract
BACKGROUND SPLIT was founded in 1995 in order to collect comprehensive prospective data on pediatric liver transplantation, including waiting list data, transplant, and early and late outcomes. Since 2011, data collection of the current registry has been refined to focus on prospective data and outcomes only after transplant to serve as a foundation for the future development of targeted clinical studies. OBJECTIVE To report the outcomes of the SPLIT registry from 2011 to 2018. METHODS This is a multicenter, cross-sectional analysis characterizing patients transplanted and enrolled in the SPLIT registry between 2011 and 2018. All patients, <18 years of age, received a first liver-only, a combined liver-kidney, or a combined liver-pancreas transplant during this study period. RESULTS A total of 1911 recipients from 39 participating centers in North America were registered. Indications included biliary atresia (38.5%), metabolic disease (19.1%), tumors (11.7%), and fulminant liver failure (11.5%). Greater than 50% of recipients were transplanted as either Status 1A/1B or with a MELD/PELD exception score. Incompatible transplants were performed in 4.1%. Kaplan-Meier estimates of 1-year patient and graft survival were 97.3% and 96.6%. First 30 days of surgical complications included reoperation (31.7%), hepatic artery thrombosis (6.3%), and portal vein thrombosis (3.2%). In the first 90 days, biliary tract complications were reported in 13.6%. Acute cellular rejection during first year was 34.7%. At 1 and 2 years of follow-up, 39.2% and 50.6% had normal liver tests on monotherapy (tacrolimus or sirolimus). Further surgical, survival, allograft function, and complications are detailed.
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Affiliation(s)
- Scott A Elisofon
- Division of Gastroenterology, Hepatology and Nutrition, Boston Children's Hospital, Boston, Massachusetts
| | - John C Magee
- Division of Surgery, University of Michigan Transplant Center, Ann Arbor, Michigan
| | - Vicky L Ng
- Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Transplant and Regenerative Medicine Center, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
| | - Simon P Horslen
- Department of Pediatrics, Seattle Children's Hospital, University of Washington School of Medicine, Seattle, Washington
| | - Vicki Fioravanti
- Section of Hepatology and Liver Transplantation, Children's Mercy Hospital, Kansas City, Missouri
| | | | | | | | - George V Mazariegos
- Division of Pediatric Transplant Surgery, Hillman Center for Pediatric Transplantation, UPMC Children's Hospital of Pittsburgh, Pittsburgh, PA, USA
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Salako O, Schilf P, Hirose M, Akindele A, Adeyemi O, Ibrahim S. Effect of massularia acuminata stem-bark extract on the mitochondrial oxygen consumption rate of cultured mouse astrocytes and primary lymphocytes. IBRO Rep 2019. [DOI: 10.1016/j.ibror.2019.09.100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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Umar A, Mohammed A, Ayo J, Danjuma N, Isa A, Ibrahim S, Muhammad M, Muhammad U, Muhammad A, Yusha’u Y. Relationship between serum glutamate and serotonin concentrations with experimental pain among nigerian adults. IBRO Rep 2019. [DOI: 10.1016/j.ibror.2019.09.092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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El-Faham A, Ibrahim S, El-Alaily H, Thabet H. THE EFFECT OF DIETARY LEVELS OF CALCIUM, PHOSPHORUS AND CHOLECALCIFEROL ON PERFORMANCE, CARCASS AND TIBIA CHARACTERISTICS OF BROILER CHICKS. ACTA ACUST UNITED AC 2019. [DOI: 10.21608/ejnf.2019.103484] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Kishk N, Mourad H, Ibrahim S, Shamloul R, Al-Azazi A, Shalaby N. Sex differences among epileptic patients: A comparison of epilepsy and its impacts on demographic features, clinical characteristics, and management patterns in a tertiary care hospital. J Neurol Sci 2019. [DOI: 10.1016/j.jns.2019.10.845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Abd Ghani F, Sridharan R, Mohd Zaki F, Md Zain RR, Ibrahim S. Dysplasia Epiphysealis Hemimelica (Trevor-Fairbank Disease): a Case Report. Hong Kong Journal of Radiology 2019. [DOI: 10.12809/hkjr1916913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Affiliation(s)
- F Abd Ghani
- Department of Radiology, Universiti Kebangsaan Malaysia Medical Centre, Malaysia
| | - R Sridharan
- Department of Radiology, Universiti Kebangsaan Malaysia Medical Centre, Malaysia
| | - F Mohd Zaki
- Department of Radiology, Universiti Kebangsaan Malaysia Medical Centre, Malaysia
| | - RR Md Zain
- Department of Pathology, Universiti Kebangsaan Malaysia Medical Centre, Malaysia
| | - S Ibrahim
- Department of Orthopaedics and Traumatology, Universiti Kebangsaan Malaysia Medical Centre, Malaysia
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Balkhair A, Al Wahaibi A, Al-Qadhi H, Al-Harthy A, Lakhtakia R, Rasool W, Ibrahim S. Gastrointestinal basidiobolomycosis: Beware of the great masquerade a case report. IDCases 2019; 18:e00614. [PMID: 31485412 PMCID: PMC6715833 DOI: 10.1016/j.idcr.2019.e00614] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [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: 07/28/2019] [Revised: 07/31/2019] [Accepted: 07/31/2019] [Indexed: 11/30/2022] Open
Abstract
We describe a previously healthy young patient with gastrointestinal basidiobolomycosis misdiagnosed as colonic malignancy. This is the first reported case in an adult patient from Oman suggesting that the disease is possibly under-recognized. Acquaintance with this exceptionally rare infection is critical for successful clinical outcome. Azoles are effective anti-fungal therapy for gastrointestinal basidiobolomycosis.
Basidiobolomycosis is rare infection caused by the saprophytic fungus Basidiobolus ranarum. Gastrointestinal basidiobolomycosis is an infrequent, albeit, increasingly reported, emerging form of the disease and typically affects immunocompetent individuals with potentially grave sequelae if unrecognized. Acquaintance with this exceptionally rare fungus and its potential for presenting as gastrointestinal mass masquerading as colonic malignancy is critical for timely diagnosis, appropriate treatment and successful clinical outcome. We report a case of gastrointestinal basidiobolomycosis masquerading as colonic malignancy in a 29-year-old Omani patient successfully treated with combination of surgery and prolonged azole antifungal therapy.
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Affiliation(s)
- A. Balkhair
- Department of Medicine, Infectious Diseases Unit, Sultan Qaboos University Hospital, Oman
- Corresponding author.
| | - A. Al Wahaibi
- Department of Medicine, Infectious Diseases Unit, Sultan Qaboos University Hospital, Oman
| | - H. Al-Qadhi
- Department of Surgery, Sultan Qaboos University Hospital, Oman
| | - A. Al-Harthy
- Department of Surgery, Sultan Qaboos University Hospital, Oman
| | - R. Lakhtakia
- Department of Pathology, Sultan Qaboos University Hospital, Oman
| | - W. Rasool
- Department of Medicine, Gastroenterology Unit, Sultan Qaboos University Hospital, Oman
| | - S. Ibrahim
- Department of Medicine, Infectious Diseases Unit, Sultan Qaboos University Hospital, Oman
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Ibrahim S. Comment on: Developmental dysplasia of the hip: why are we still operating on them? A plea for institutional newborn clinical screening. Singapore Med J 2019; 60:322. [DOI: 10.11622/smedj.2019060] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Slaven S, Ibrahim S, Tantibhedhyangkul J, Radeva M, Flyckt R. The prevalence of sleep disorders in an infertile female population. Fertil Steril 2018. [DOI: 10.1016/j.fertnstert.2018.07.456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Mansor N, Abdul-Rashid AH, Ibrahim S. Paediatric Femur Fractures: A Plea for Minimally Invasive Surgery to Prevent Osteomyelitis. Malays Orthop J 2018; 12:73-74. [PMID: 30112136 PMCID: PMC6092544 DOI: 10.5704/moj.1807.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Affiliation(s)
- N Mansor
- Department of Orthopaedics and Traumatology, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - A H Abdul-Rashid
- Department of Orthopaedics and Traumatology, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - S Ibrahim
- Department of Orthopaedics and Traumatology, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
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Ibrahim S, Girault A, Babin L, Guéguinou M, Potier-Cartereau M, Vandier C, Paintaud G, Lecomte T, Raoul W. PO-041 TNF pathway in metastatic colorectal cancer according to RAS status and implication of potassium channels. ESMO Open 2018. [DOI: 10.1136/esmoopen-2018-eacr25.86] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Ahmed HF, Straubinger RK, Hegazy YM, Ibrahim S. Subclinical mastitis in dairy cattle and buffaloes among small holders in Egypt: Prevalence and evidence of virulence of Escherichia coli causative agent. Trop Biomed 2018; 35:321-329. [PMID: 33601806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
This study aimed first to estimate the prevalence of subclinical mastitis (SCM) among dairy cows and buffaloes of smallholders who sell milk directly to consumers through bulk tanks of milk distributors. The second aim is to estimate the prevalence of Escherichia coli in milk of SCM cases and identify its virulence genes and to emphasize the public health risk form drinking this milk. A total of 227 and 174 dairy cows and buffaloes, respectively from Kafrelsheikh Governorate, Egypt were examined with California Mastitis Test (CMT) to estimate the prevalence of SCM. Samples were also screened for E. coli using classical bacteriological and molecular methods. The prevalence of CMT-positive cows and buffaloes samples examined was 47.4% (49.9% and 44.3% for cows and buffaloes, respectively). Cows were found to be at a higher risk of getting high CMT score than buffaloes. E. coli was detected bacteriologically in 16.4% and in 27.2% of the CMT-positive cows and buffalo samples, respectively. A total of 83.1% and 75.6% of isolates were confirmed as E. coli using PCR technique. A multiplex PCR assay was used to identify five virulence genes in the E. coli isolates; the eae gene for enteropathogenic E. coli, stx for Shiga toxin-producing E. coli, elt and est for enterotoxigenic E. coli, and the hlyA of the enterohemolysin gene for enterohemorrhagic E. coli. Only one E. coli strain identified carried two virulence genes (eae and est). The high prevalence of SCM among dairy cows and buffaloes in the study area indicated that there is high risk to consumers who consume milk of these animals. Also, control of SCM is a prerequisite among smallholders in Egypt in order to minimize its deleterious effects such as microbial antibiotic resistance and public health hazards. To our knowledge, this is the first study that highlights the ecology of virulence by E. coli causing SCM in Kafrelsheikh governorate, Egypt. This study offers the basis for further phenotypic and molecular characterization of E. coli found in raw milk in order to guarantee safe consumption of raw milk and milk products.
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Affiliation(s)
- H F Ahmed
- Food Hygiene Department, Faculty of Veterinary Medicine, Kafrelsheikh University, 33516, Kafrelsheikh, Egypt
| | - R K Straubinger
- Bacteriology and Mycology, Institute for Infectious Diseases and Zoonoses, LMU Munich, Veterinärstraße 13, 80539 München, Germany
| | - Y M Hegazy
- Animal Medicine Department, Faculty of Veterinary Medicine, Kafrelsheikh University, 33516, Kafrelsheikh, Egypt
| | - S Ibrahim
- Department of Mastitis and Neonatal Diseases, Animal Reproduction Research Institute (ARRI), Giza, Egypt
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