Classifying Kidney Disease in a Vervet Model Using Spatially Encoded Contrast-Enhanced Ultrasound Perfusion Parameters.

Early stages of diabetic kidney disease (DKD) are difficult to diagnose in patients with type 2 diabetes. This work was aimed at identifying contrast-enhanced ultrasound (CEUS) perfusion parameters, a microcirculatory biomarker indicative of early DKD progression. CEUS kidney flash-replenishment data were acquired in control, insulin resistant and diabetic vervet monkeys (N = 16). By use of a mono-exponential model, time-intensity curve parameters related to blood volume (A), velocity (ß) and flow rate (perfusion index [PI]) were extracted from 10 concentric kidney layers to study spatial perfusion patterns that could serve as strong indicators of disease. Mean squared error (MSE) was used to assess model performance. Features calculated from the perfusion parameters were inputs for the linear regression models to determine which features could distinguish between cohorts. The mono-exponential model performed well, with average MSEs (±standard deviation) of 0.0254 (±0.0210), 0.0321 (±0.0242) and 0.0287 (±0.0130) for the control, insulin resistant and diabetic cohorts, respectively. Perfusion index features, with blood pressure, were the best classifiers between cohorts (p < 0.05). CEUS has the potential to detect early microvascular changes, providing insight into disease-related structural changes in the kidney. The sensitivity of this technique should be explored further by assessing various stages of DKD.

Privacy, confidentiality, security and patient safety concerns about electronic health records.

AIMS: This study explored concerns among nurses working in the United Arab Emirates associated with the use of electronic health records, including privacy, confidentiality, security and patient safety. BACKGROUND: Given the widespread implementation of electronic health records, there are concerns about data integrity that could jeopardize healthcare quality. Addressing nurses' concerns about data integrity and safety is critical to inform health policies and promote public trust. METHODS: Nurses working in healthcare settings in the United Arab Emirates (N = 562) were invited to share their concerns about data integrity and patient safety using a mixed-method approach. Data were collected between January and June 2018 via questionnaires and focus group interviews. Following a survey of nurses' concerns about privacy, confidentiality, security and patient safety in electronic health records, six focus groups were held to gain deeper insights about their concerns. Major themes that emerged from the focus groups were extracted to align with the main sections of the questionnaire. RESULTS: Nurses expressed concern over the security of electronic health records (n = 270, 48%). Administrative-related security, inadequate training and access by unauthorized users were the most frequently reported concerns. The main patient safety concerns were associated with non-technological factors, including lack of audit by staff, poor communication with technology vendors and length of time required for documentation. The focus group results reflected similar issues, with an additional theme being inconsistency in data integrity policies. CONCLUSIONS AND IMPLICATIONS FOR NURSING/HEALTH POLICY: Frontline nurse managers need to integrate pragmatic policies to support staff compliance with the code of ethics when using online data. Nurses must follow workplace policies that foster reporting of risks to online incident systems to ensure data integrity. A unified health policy based on multidisciplinary partnership is critical to safeguard online data and promote public trust.

[Chronic pelvic pain syndrome]. / Le syndrome douloureux pelvien chronique ou "prostatite chronique".

Chronic prostatitis are caused by infection in 5-10% of cases and other entities are called "chronic pelvic pain syndrome". The current classifications are based on the presence or absence of inflammation or infection in the prostatic secretions. The new concept of clinical phenotype "UPOINT" offers six domains (urinary, psychosocial, organ-specific, infectious, neurological, systemic and related to muscle tension) and can guide treatment according to the phenotype expressed by the patient. The therapeutic approach is based on the first use of antibiotics with or without alpha-blockers. Depending on clinical response, supportive treatment should be considered. The role of psychological support remains essential. Few studies of effectiveness of a level 1 of evidence are available and the chronic pelvic pain syndrome remains a controversial entity in the etiology whose treatments are empirical. The authors review current knowledge on the best treatment suited to the "chronic prostatitis".

C-Peptide versus insulin: relationships with risk biomarkers of cardiovascular disease in metabolic syndrome in young arab females.

Background. Obesity is a major health concern and is associated with metabolic syndrome (MetS) that increases the risk for cardiovascular disease (CVD). Since little is known about the relationships between MetS components and CVD in overweight/obese young Arab females, our study aimed at examining these relationships and further to explore the associations between connecting peptide (C-peptide) and insulin with these biomarkers. Subjects and Methods. In this cross-sectional study, 80 apparently healthy young Arab females were recruited and grouped by their body mass index (BMI) into normal-weight (GI) and overweight/obese (GII) groups. Results. The two groups significantly differed in BMI, waist circumference (WC) and values of biomarkers, namely, leptin, fasting insulin, uric acid (UA), insulin resistance (HOMA-IR), C-peptide, high-sensitivity C-reactive protein (hs-CRP), high-density lipoprotein cholesterol (HDL-C), systolic blood pressure (SBP), and diastolic blood pressure (DBP). C-peptide significantly correlated with WC, leptin, UA, and HDL-C and was predicted by three biomarkers; UA, WC and HDL-C. Whereas, insulin significantly correlated with only two biomarkers including leptin and DBP and was predicted by UA and DBP. Conclusions. The present study highlighted the association between MetS and CVD in young Arab females and the possible role of C-peptide in the prediction of CVD.

Evaluation of the health-related quality of life of Emirati people with diabetes: integration of sociodemographic and disease-related variables.

This study aimed to evaluate the health-related quality of life (HRQOL)of Emirati people with diabetes and to explore the sociodemographic and disease-related variables affecting it. The Arabic version of the World Health Organization quality of life questionnaire, short version (WHOQOL-BREF) was administered to 200 people with diabetes. The overall mean score was 63.1 (SD 15.0), ranging from 61.5 to 65.5 on subscales. Three factors significantly influenced the total HRQOL: presence of diabetes complications, duration of diabetes and marital status. Presence of complications was the most powerful variable influencing the 4 domains of HRQOL, especially the physical domain. Duration of diabetes did not influence the psychological domain and marital status did not influence the physical and psychological domains. The study provides further evidence of the usefulness and reliability of the Arabic WHOQOL-BREF.

Synthesis and evaluation of a thymidine analog for positron emission tomography study of tumor DNA proliferation in vivo.

This study describes the synthesis, radiolabelling and biological evaluation of 5-(2,4-difluoro-5-[18F]fluoromethyl-phenyl)-2-hydroxymethyl-tetrahydrofuran-3-ol, 13. Radiolabelling was achieved by reaction of the tosylate 3 with K[18F] in the presence of Kryptofix 222. Good stability in saline and serum solutions at physiological temperatures in vitro was observed. A cell incorporation study of 13 using SW1222 tumor cells showed a linear uptake, unfortunately, in vivo studies indicated that 13 was undergoing defluorination. Rapid defluorination of the radiotracer was confirmed by an in vitro stability study in blood plasma. Finally, a comparison between the DNA uptake of 13 and tritiated thymidine was performed in vitro to asses the potential utility of more stable analogs. These studies showed that 13 and its analogs are unsuitable as potential tracers to image DNA proliferation and highlighted the difficulty in predicting the in vivo stability of novel radiotracers.

Seasonal fluctuations and hypobiosis of gastro-intestinal nematodes of Awassi lambs in Iraq.

The results of an epidemiological study involving the estimation of worm counts of gastro-intestinal nematodes of lambs, during the period December 1978 to November 1979, in the Baghdad area are reported. Ostertagia spp. and Trichostrongylus spp. were the most abundant nematodes in the weaned lambs used in this study. Ostertagia spp. infection was present throughout the period of observation, the level of infection being the highest during early summer (May-June). Trichostrongylus spp. infection, however, reached a peak during July-August. In the tracer lambs the maximum population of Ostertagia spp. was found during February-March, while that of Trichostrongylus spp. could be observed only after mid-June. Other nematodes encountered were Haemonchus contortus and Trichuris sp. but they were only present in small numbers. The proportion of inhibited larvae of Ostertagia spp. was markedly high during the dry summer months. Little inhibition was noticed during autumn and the early winter months. It appears that if the seasonal inhibition of Ostertagia spp. in Iraq is brought about by an environmental stimulus acting upon pre-parasitic larval stages, that stimulus cannot be chilling or falling temperatures, as observed in temperate northern zones.

Epidemiology of gastrointestinal parasites of Awassi sheep in Iraq.

Studies on the epidemiology of gastrointestinal nematodes of sheep, conducted at two different farms in the Baghdad area, in 1979, revealed two peaks in worm egg counts in ewes, one in spring and the other in autumn; the latter coincided with the lambing season. Similarly in lambs, two peaks of infection were apparent, but the spring peak was not so well defined. During the hot and dry summer months of Iraq, helminthic infection was at a low level. Faecal culture for larvae and their identification indicated the predominance of Haemonchus contortus infection in the ewes and that of Ostertagia and Trichostrongylus spp. in the lambs examined, Trichostrongylus infection predominating during the hot, dry period of the year. The self-cure phenomenon as well as preparturient rise in egg counts, as reported in other countries, was also observed during this study.

Experimental approach to the pathogenesis of the anomalies of amniotic disease.

By intra-adnexal injection of glucose in the rabbit embryo, we were able to stimulate all the anomalies associated with "Amniotic Disease". Since we were even able to obtain amniotic bands, this study provides an excellent experimental model of this disease. Resulting lesions occur early in development, corresponding to the first trimester of human gestation. All of the anomalies can ultimately be explained by the destruction of the most superficial cells: epiblastic cells of the embryo and the amnion, subjacent mesenchyme, and endothelial cells. The subsequent lack of interaction between these cells and the importance of the anatomical localizations of resulting hematomas can lead to the pathogenetic approach to this disease. In light of the present study, the disease appears to be caused by an external factor within the amniotic fluid. The exact nature of the destructive agent(s) remains a mystery in man.