Diagnostic validity and reliability of BT-RADS in the management of recurrent high-grade glioma.

BACKGROUND AND PURPOSE: BT-RADS is a new framework system for reporting the treatment response of brain tumors. The aim of the study was to assess the diagnostic performance and reliability of the BT-RADS in predicting the recurrence of high-grade glioma (HGG). MATERIALS AND METHODS: This prospective single-center study recruited 81 cases with previously operated and pathologically proven HGG. The patients underwent baseline and follow-up contrast-enhanced MRI (CE-MRI). Two neuro-radiologists with ten years-experience in neuroimaging independently analyzed and interpreted the MRI images and assigned a BT-RADS category for each case. To assess the diagnostic accuracy of the BT-RADS for detecting recurrent HGG, the reference standard was the histopathology for BT-RADS categories 3 and 4, while neurological clinical examination and clinical follow up were used as a reference for BT-RADS categories 1 and 2. The inter-reader agreement was assessed using the Cohen's Kappa test. RESULTS: The study included 81 cases of HGG, of which 42 were recurrent and 39 were non-recurrent HGG cases based on the reference test. BT-RADS 3B was the best cutoff for predicting recurrent HGG with a sensitivity of 90.5 % to 92.9 %, specificity of 76.9 % to 84.6 %, and accuracy of 83.9 % to 88.9 %, based on both readers. The BT-RADS showed a substantial inter-reader agreement with a K of 0.710 (P = 0.001). CONCLUSIONS: The BT-RADS is a valid and reliable framework for predicting recurrent HGG. Moreover, BT-RADS can help neuro-oncologists make clinical decisions that can potentially improve the patient's outcome.

Hemophagocytic Lymphohistiocytosis syndrome (HLH) associated with acute pancreatitis: A case report.

Hemophagocytic Lymphohistiocytosis syndrome is fatal hyper-inflammatory condition due to over-activation of the immune system, being of primary and secondary types. This case report emphasizes the difficulty and challenge in and of the HLH diagnosis, and therapy should be employed promptly given the high mortality associated with HLH.

Long-term results of hyperopic ablations using alcohol-assisted PRK and FS-LASIK: comparative study.

PURPOSE: To evaluate the long-term visual and refractive outcomes of hyperopic excimer ablation using alcohol-assisted photorefractive keratectomy (PRK) and femtosecond laser-assisted laser in situ keratomileusis (FS-LASIK). SETTING: American University of Beirut Medical Center, Beirut, Lebanon. DESIGN: Retrospective, matched comparative study. METHODS: Eyes that underwent alcohol-assisted PRK were compared to matched eyes that underwent FS-LASIK. All patients were followed up for at least 3 years after surgery. The refractive and visual outcomes of each group were compared at different postoperative time points. The main outcome measures were spherical equivalent deviation from target (SEDT), manifest refraction, and visual acuity. RESULTS: 83 eyes underwent alcohol-assisted PRK and 83 matched eyes underwent FS-LASIK. Preoperative manifest refraction spherical equivalent was 2.44 ± 1.18 diopters (D) and 2.20 ± 0.87 D ( P = .133) in the PRK and FS-LASIK groups, respectively. Preoperative manifest cylinder was -0.77 ± 0.89 D and -0.61 ± 0.59 D ( P = .175) for the PRK and LASIK groups, respectively. 3 years postoperatively, SEDT was 0.28 ± 0.66 D and 0.40 ± 0.56 D for the PRK and LASIK groups, respectively ( P = .222), whereas manifest cylinder was -0.55 ± 0.49 D and -0.30 ± 0.34 D for PRK and LASIK, respectively ( P < .001). The mean difference vector was 0.59 ± 0.46 for PRK and 0.38 ± 0.32 for LASIK ( P < .001). 13.3% of PRK eyes and 0% of LASIK eyes had >1 D of manifest cylinder ( P = .003). CONCLUSIONS: Both alcohol-assisted PRK and FS-LASIK are safe and effective for the treatment of hyperopia. PRK induces slightly more postoperative astigmatism than LASIK. Larger optical zones and recently introduced ablation profiles that lead to a smoother ablation surface might improve the clinical results of hyperopic PRK.

Production of nutty-like flavour from soybean protein isolate hydrolysate pretreated or assisted by microwave irradiation: impact of encapsulation on nutty flavour quality.

The aim of this study was to prepare a nutty-like flavour from enzymatic hydrolysates of soybean protein isolate pretreated or assisted by microwave heating. In both cases the time of microwave heating was optimized and degree of hydrolysis (DH) and content of free amino acids in each hydrolysate were determined and compared with those of hydrolysate prepared by conventional method (E-HSC). The hydrolysates showed the best results were used as main precursors of nutty flavour. The generated volatiles were subjected to GC-MS analysis and odour evaluation. The effect of encapsulation and storage on the nutty flavour was evaluated. The results revealed that the hydrolysates pretreated (E-HSMP7) or assisted (E-HSMA6) by microwave at 7 and 6 min, respectively showed a significant increase in DH. The nutty flavour generated from these hydrolysates (NFMP7 and NFMA6) were dominated with pyrazines whereas, the volatiles from E-HSC (NFC) dominated with furans. NFMA6 showed the highest intensity of nutty and overall acceptability notes, compared with NFMP7 and NFC. Encapsulation resulted in a significant decrease in pyrazines, which are responsible for the nutty note. The significant increase in nutty aroma intensity of the stored encapsulated sample was correlated to the increase in pyrazines.

Ten-Year Outcomes of Percutaneous Coronary Intervention Versus Coronary Artery Bypass Grafting for Patients with Type 2 Diabetes Mellitus Suffering from Left Main Coronary Disease: A Meta-Analysis.

INTRODUCTION: In this meta-analysis, we aimed to systematically compare the 10-year outcomes of percutaneous coronary intervention (PCI) versus coronary artery bypass grafting (CABG) in patients with type 2 diabetes mellitus (T2DM) suffering from left main coronary artery disease (LMCD). METHODS: Medical Literature Analysis and Retrieval System Online (MEDLINE), http://www.ClinicalTrials.gov , Excerpta Medica dataBASE (EMBASE), Cochrane Central, Web of Science, and Google scholar were searched for publications comparing 10-year outcomes of PCI versus CABG in patients with T2DM suffering from LMCD. Cardiovascular outcomes were considered as the clinical endpoints. Statistical analysis was carried out using RevMan software (version 5.4). Risk ratios (RR) with 95% confidence intervals (CI) were used to represent the data after analysis. RESULTS: Eight studies (three randomized trials and five observational studies) with a total number of 3835 participants with T2DM were included in this analysis; 2340 participants were assigned to the PCI group and 1495 participants were assigned to the CABG group. Results of this analysis showed that mortality (RR 0.85, 95% CI 0.73-1.00; P = 0.05), myocardial infarction (RR 0.53, 95% CI 0.35-0.80; P = 0.002), repeated revascularization (RR 0.34, 95% CI 0.26-0.46; P = 0.00001), and target vessel revascularization (RR 0.26, 95% CI 0.18-0.38; P = 0.00001) were significantly higher with PCI when compared to CABG in these patients with diabetes and LMCD. Major adverse cardiac and cerebrovascular events were also significantly higher with PCI at 10 years (RR 0.67, 95% CI 0.49-0.92; P = 0.01). However, CABG was associated with a significantly higher risk of stroke (RR 2.16, 95% CI 1.39-3.37; P = 0.0007). CONCLUSIONS: During a long-term follow-up time period of 10 years, PCI was associated with worse clinical outcomes compared to CABG in these patients with T2DM suffering from LMCD. However, a significantly higher risk of stroke was observed with CABG. This piece of information might be vital in order to carefully choose and prevent complications following revascularization in such patients.

HDL particle size is increased and HDL-cholesterol efflux is enhanced in type 1 diabetes: a cross-sectional study.

AIMS/HYPOTHESIS: The prevalence of atherosclerosis is increased in type 1 diabetes despite normal-to-high HDL-cholesterol levels. The cholesterol efflux capacity (CEC) of HDL is a better predictor of cardiovascular events than static HDL-cholesterol. This cross-sectional study addressed the hypothesis that impaired HDL function contributes to enhanced CVD risk within type 1 diabetes. METHODS: We compared HDL particle size and concentration (by NMR), total CEC, ATP-binding cassette subfamily A, member 1 (ABCA1)-dependent CEC and ABCA1-independent CEC (by determining [3H]cholesterol efflux from J774-macrophages to ApoB-depleted serum), and carotid intima-media thickness (CIMT) in 100 individuals with type 1 diabetes (37.6 ± 1.2 years; BMI 26.9 ± 0.5 kg/m2) and 100 non-diabetic participants (37.7 ± 1.1 years; 27.1 ± 0.5 kg/m2). RESULTS: Compared with non-diabetic participants, total HDL particle concentration was lower (mean ± SD 31.01 ± 8.66 vs 34.33 ± 8.04 µmol/l [mean difference (MD) -3.32 µmol/l]) in participants with type 1 diabetes. However, large HDL particle concentration was greater (9.36 ± 3.98 vs 6.99 ± 4.05 µmol/l [MD +2.37 µmol/l]), resulting in increased mean HDL particle size (9.82 ± 0.57 vs 9.44 ± 0.56 nm [MD +0.38 nm]) (p < 0.05 for all). Total CEC (14.57 ± 2.47%CEC/4 h vs 12.26 ± 3.81%CEC/4 h [MD +2.31%CEC/4 h]) was greater in participants with type 1 diabetes relative to non-diabetic participants. Increased HDL particle size was independently associated with increased total CEC; however, following adjustment for this in multivariable analysis, CEC remained greater in participants with type 1 diabetes. Both components of CEC, ABCA1-dependent (6.10 ± 2.41%CEC/4 h vs 5.22 ± 2.57%CEC/4 h [MD +0.88%CEC/4 h]) and ABCA1-independent (8.47 ± 1.79% CEC/4 h vs 7.05 ± 1.76% CEC/4 h [MD +1.42% CEC/4 h]) CEC, were greater in type 1 diabetes but the increase in ABCA1-dependent CEC was less marked and not statistically significant in multivariable analysis. CIMT was increased in participants with type 1 diabetes but in multivariable analysis it was only associated negatively with age and BMI. CONCLUSIONS/INTERPRETATION: HDL particle size but not HDL-cholesterol level is independently associated with enhanced total CEC. HDL particle size is greater in individuals with type 1 diabetes but even after adjusting for this, total and ABCA1-independent CEC are enhanced in type 1 diabetes. Further studies are needed to understand the mechanisms underlying these effects, and whether they help attenuate progression of atherosclerosis in this high-risk group. Graphical abstract.

Adverse Drug Events Observed with the Novel Sodium/Glucose Co-Transporter 2 Inhibitor Ipragliflozin for the Treatment of Patients with Type 2 Diabetes Mellitus: A Systematic Review and Meta-analysis of Randomized Studies.

INTRODUCTION: Type 2 diabetes mellitus (T2DM) is becoming a major issue worldwide. To effectively control the blood sugar of patients with T2DM, several novel oral hypoglycemic agents (OHAs) are being developed. Sodium/glucose co-transporter 2 (SGLT 2) inhibitors have recently shown beneficial outcomes in patients with T2DM. In this analysis, we aimed to systematically compare the adverse drug events observed with ipragliflozin versus placebo for the treatment of patients with T2DM. METHODS: http://www.ClinicalTrials.gov , the bibliographic database of life science and biomedical information MEDLINE, EMBASE and the Cochrane Central were searched for English publications satisfying the inclusion and exclusion criteria of this study. Adverse drug events were the end points in this analysis. The latest version (5.4) of the RevMan software was used to analyze the data, and risk ratios (RR) with 95% confidence intervals (CI) were used to represent the data post analysis. RESULTS: Eight randomized studies with a total of 1519 participants with T2DM were included in this analysis whereby total treatment-emergent adverse events (RR: 1.06, 95% CI: 0.96-1.16; P = 0.26), including mild (RR: 0.95, 95% CI: 0.79-1.13; P = 0.54), moderate (RR: 1.04, 95% CI: 0.72-1.51; P = 0.83) and severe treatment-emergent adverse events (RR: 0.72, 95% CI: 0.26-1.96; P = 0.52), were not significantly different in those patients who were assigned to ipragliflozin versus placebo for the treatment of T2DM. Moreover, drug-related adverse events (RR: 1.04, 95% CI: 0.69-1.58; P = 0.85), adverse events leading to drug discontinuation (RR: 1.09, 95% CI: 0.57-2.10; P = 0.79), urinary tract infection (RR: 1.03, 95% CI: 0.60-1.77; P = 0.91), naso-pharyngitis (RR: 0.54, 95% CI: 0.19-1.52; P = 0.25), constipation (RR: 1.94, 95% CI: 0.90-4.20; P = 0.09), dizziness (RR: 0.81, 95% CI: 0.20-3.23; P = 0.76), gastrointestinal disorders (RR: 0.96, 95% CI: 0.68-1.36; P = 0.82) and dehydration (RR: 2.26, 95% CI: 0.38-13.43; P = 0.37) were also not significantly different. However, genital infection (RR: 4.53, 95% CI: 1.48-13.85; P = 0.008) and hypoglycemia (RR: 1.68, 95% CI: 1.03-2.74; P = 0.04) rates were significantly higher in the ipragliflozin group. CONCLUSIONS: The current analysis showed ipragliflozin to be associated with significantly higher genital infection rates compared to placebo, whereas no significant difference was observed compared to the other adverse drug events in these patients with T2DM. In addition, hypoglycemia was also not significantly different following sensitivity analysis.

Peripheral Vascular Disease and Implication of Nursing Practice: A Brief Literature Review.

Nowadays nurse practitioners are working in several acute hospital settings in different specialized departments. For decades, studies have shown the implications of nurse practice in peripheral vascular disease (PVD) and peripheral vascular intervention (PVI) to have several major benefits. However, there are very limited studies and data on this particular aspect. In this literature review, we briefly discuss the implication of nursing practice in PVD/PVI. This review briefly shows that nursing practice has a major contribution and implication in the treatment of patients with PVD or PVI, especially in patients with diabetes mellitus. From available research, we briefly discuss the implication of nursing practice pre- and postoperatively for PVI. Nurses also contribute significantly in catheter-directed thrombolytic therapy, in smoking cessation programs organized for patients with PVD, and in screening patients for PVD. The vascular nurse practitioners are also involved in providing healthcare advice in order to reduce the risk of disease progression. The major lack of research in this particular field should further inspire scientists to develop and carry out research to further investigate and demonstrate the contribution of nurses in the treatment and management of PVD or PVI, which is gradually becoming a major issue.

Nanotechnology for enhancing the production of meat-like flavour from enzymatic hydrolyzed soybean protein isolate.

BACKGROUND: Enzymatic hydrolyzed vegetable proteins have been recommended as safe precursors of pro- cess flavours. However, the degree of hydrolysis limits their production on an industrial scale. Nanotechnology can enhance the enzymatic hydrolysis of soybean protein. Therefore, the aim of the present study was to use the enzymatic hydrolyzed soybean protein isolate (E-SPI) nanoparticles for producing a high yield of meat-like process flavour. METHODS: Ball milling, high-speed homogenization and ultra-sonication were used for prepa- ration of SPI nanoparticles with average range 10–17 nm. The volatile compounds were analyzed by head- space solid phase microextraction (HS-SPME) and gas chromatography coupled with mass spectrometry (GC-MS). The odour attributes of beefy, roasty, savoury, sulphurous and overall acceptability were selected to describe the meat-like process aroma. RESULTS: The total volatiles in the headspace of the meat-like process flavour based on SPI nanoparticles showed a higher yield compared with the untreated sample. Thiols containing compounds, especially the potent odorants of meat-like flavour, were predominant in both samples. However, their yield was significantly higher in the SPI nanoparticles sample. An agreement was found between the intensity of the attributes selected and the aroma composition of the two meat-like flavours investigated. CONCLUSIONS: The results of this study suggest that using protein nanoparticles as the main precursors of the process flavours is considered a new chance for innovation in nanoscience. Future studies will be carried out on improving the quality and quantity of vegetable protein nanoparticles that can be used as precursors of another process flavours.

Duration of Dual Antiplatelet Therapy and Late Stent Thrombosis Following Percutaneous Coronary Intervention with Second-Generation Drug-Eluting Stents: A Simple Meta-Analysis of Randomized Controlled Trials.

INTRODUCTION: The aim of this simple meta-analysis was to systematically compare the occurrence of late and very late stent thrombosis with a short versus a longer duration of dual anti-platelet therapy (DAPT) use following the implantation of second-generation drug-eluting stents (DES). METHODS: Randomized controlled trials that compared short- and long-term DAPT use following percutaneous coronary intervention (PCI) with DES and that reported late (> 30 days but < 1 year) and very late (> 1 year) stent thromboses were searched from the bibliographic database of life sciences and biomedical information, which is also known as MEDLINE, as well as other searched databases including EMBASE, the Cochrane Central and http://www.ClinicalTrials.com . Statistical analysis was carried out using RevMan software [odds ratios (OR) and 95% confidence intervals (CIs) represented the results]. RESULTS: This simple analysis consisted of five randomized controlled trials with a total of 7142 patients. The current results showed no significant difference in late stent thrombosis associated with a shorter or longer duration of DAPT use (OR 0.98, 95% CI 0.30-3.18; P = 0.97, I2 = 0%). The result for very late stent thrombosis was also not significantly different (OR 0.30, 95% CI 0.03-2.95; P = 0.31). CONCLUSIONS: This simple analysis showed no impact of DAPT duration on the occurrence of late and very late stent thrombosis. Similar late and very late stent thrombosis rates were observed with 6-month versus 12-month duration of DAPT use following PCI with second-generation DES.

Infrared and Raman spectroscopic studies of Mn2+ ions doped in strontium alumino borate glasses: Describes the role of Al2O3.

Strontium alumino borate glasses doped with Mn2+ ions (SABM) have been prepared and characterized by XRD, density, Electron paramagnetic resonance (EPR), FT-IR and Raman to investigate the spectral and physical properties of the present glass samples. The FTIR spectra revealed the presence of BO3 and BO4 structural units in SABM glasses. The IR peak at ~467 and ~679 cm-1 assigned as the vibration of metal cations (Sr2+), MnO bond vibrations and bending vibration of AlO in [AlO4] units. The Raman band ~786 cm-1 establishes the presence of AlO4 units. It has been found that an increasing the Al2O3 content increases the bond length of the AlO bond in AlO4 which leads to increase molar volume and decrease density. Differential scanning calorimetry (DSC) studies indicated that the glass transition temperature (Tg) decreases with increase of Al2O3. Evaluated g and A values from EPR spectra gave the conformation about the ionic bonding between the Mn2+ and its neighbouring oxygen ions.

Potential hazards of bisphenol A exposure to semen quality and sperm DNA integrity among infertile men.

Bisphenol A (BPA) is an endocrine disruptor that is widely produced as a by-product in the plastics industry. The aim of the current study was to identify any association between urinary BPA levels and infertility related factors in patients who presented to the andrology clinic of a university hospital in Upper Egypt. In this case-control study, urinary BPA levels in 50 infertile patients and 50 matched controls were measured by high-performance liquid chromatography. Semen quality (sperm concentration, morphology, and motility) and oxidative stress (total antioxidant activity and malondialdehyde levels) were determined along with sperm DNA damage via alkaline comet assays. BPA concentrations were similarly high in urine samples from all infertile patients and fertile controls, with median values of 24.2 µg/l and 20.9 µg/l, respectively. Total BPA levels were negatively associated with semen quality and antioxidant levels, and positively correlated with DNA damage, especially with multiple semen profile defects, alongside seminal-plasma lipid peroxidation.

Diversity and antagonistic potential of bacteria isolated from marine grass Halodule uninervis.

The aim of this study was to isolate bacteria from sea grass, Halodule uninervis collected from the coastal area of Jeddah, Saudi Arabia and to screen them for antifungal and enzymatic activities. We have isolated 162 rhizo and endophytic bacteria from soil, roots, and leaves of the sea grass. Antifungal screening of isolated bacteria revealed 19 strains (11.7%) capable to inhibit growth of four pathogenic fungi, Pythium ultimum, Phytophthora capsici, pyricularia oryzae, and Rhizoctonia solani in an in vitro assay. Taxonomic and phylogenetic analyses on the basis of 16S rRNA gene sequence revealed 97-99.9% sequence identity to recognized species. Bacillus, Staphylococcus, Jeotgalicoccus, and Planococcus, within the Phylum Firmicutes, Kocuria, Arthrobacter, Ornithinimicrobium and Corynebacterium (Actinobacteria), Sulfitobacter, Roseivivax, Ruegeria (α-Proteobacteria), Moraxella, and Vibrio (γ-Proteobacteria), were isolated. Strains belong to Phylum Firmicutes remain dominant antagonistic bacteria in this study. Further hydrolytic enzyme production was determined for these antagonistic bacteria. Our results demonstrated that the sea grass represents an important source of diverse antagonistic bacteria capable of producing antifungal metabolite.

Epidemiology of hydatid disease in Qatar: a hospital based study from 2000 to 2013.

OBJECTIVES: To describe the epidemiological and clinical profile, treatment and outcome for hydatid diseases among the patients admitted to Hamad General Hospital. METHODS: This retrospective study was carried out on patients admitted to Hamad General Hospital between 1st January 2000 and 31st December 2013. Descriptive statistics including range and percentage were used in analyzing the patient characteristics and laboratory parameters. RESULTS: Hydatid disease was confirmed in 32 patients. The mean age of them was (35.59±13.00) years (range: 11-67 years) and 90.6% (29/32) of them were non-Qataris with male predominance. The main presenting symptom was abdominal pain 71.9% (23/32) followed by fever 45.9% (15/32). The main presenting sign was hepatomegaly 62.5% (20/32). Single organ involvement was found in 87.5% (28/32) and the common site involved was the liver 81.3% (26/32) followed by the lung 15.6% (5/32). The diagnosis was established by abdominal ultrasound and/or abdominal CT and confirmed by serology in all patients. The diagnosis was confirmed by histology in 90.6% (29/32) patients. All patients received albendazole, and 90.6% (29/32) patients had surgical intervention. Duration of albendazole therapy was (53.9±51.5) d. All patients were cured. CONCLUSIONS: Hydatid disease is uncommon in Qatar. It occurs mainly among non-Qataris from endemic areas and affects the liver mostly. Surgical intervention and albendazole administration are highly effective.

Comparison between short- and long-acting erythropoiesis-stimulating agents in hemodialysis patients: target hemoglobin, variability, and outcome.

PURPOSE: Maintaining target hemoglobin (Hb) with minimal variability is a challenge in hemodialysis (HD) patients. The aim of this study is to compare the long- and short-acting erythropoietin-stimulating agents such as Aranesp and Eprex in achieving these targets. METHODS: Randomized, prospective, open-labeled study of 24 weeks includes stable patients on HD >3 months, age >18 years, and on Eprex for >3 months. Patients were randomized into two groups: A-(Aranesp group):HD patients on Eprex Q TIW or BIW were converted to Aranesp Q weekly, by using the conversion factor of 200:1 and those on Eprex Q weekly to Aranesp Q 2 weeks; B-(Eprex group):patients continued on Eprex treatment. Hemoglobin target was set at (105-125 g/l). Primary end points were percentage of patients achieving target Hb, hemoglobin variability, and number of dose changes in each group. RESULTS: This study consisted of 139 HD patients: 72 in the Aranesp and 67 in the Eprex-mean (SD) age 54 (16.2) years, 77 (55 %) males. About 46 % were diabetic. Target Hb achieved in 64.8 % of the Aranesp and 59.7 % in the Eprex (p = 0.006). Hb variability was less frequent in the Aranesp group (p = 0.2). Mean number of dose changes was 1.3 (0.87) in the Aranesp and 1.9 (1.2) in the Eprex (p < 0.001). There was 1 vascular access thrombosis in the Aranesp and 8 in the Eprex (p < 0.001). There was no difference in hospitalization and death number between the 2 groups. CONCLUSIONS: Aranesp Q weekly or every 2 weeks is more efficient in achieving target Hb, with less dose changes and minor vascular access complications.

Epidemiology of hydatid disease in Qatar: A hospital based study from 2000 to 2013

Objectives: To describe the epidemiological and clinical profile, treatment and outcome for hydatid diseases among the patients admitted to Hamad General Hospital. Methods: This retrospective study was carried out on patients admitted to Hamad General Hospital between 1st January 2000 and 31st December 2013. Descriptive statistics including range and percentage were used in analyzing the patient characteristics and laboratory parameters. Results: Hydatid disease was confirmed in 32 patients. The mean age of them was (35.59±13.00) years (range: 11-67 years) and 90.6% (29/32) of them were non-Qataris with male predominance. The main presenting symptom was abdominal pain 71.9% (23/32) followed by fever 45.9% (15/32). The main presenting sign was hepatomegaly 62.5% (20/32). Single organ involvement was found in 87.5% (28/32) and the common site involved was the liver 81.3% (26/32) followed by the lung 15.6% (5/32). The diagnosis was established by abdominal ultrasound and/or abdominal CT and confirmed by serology in all patients. The diagnosis was confirmed by histology in 90.6% (29/32) patients. All patients received albendazole, and 90.6% (29/32) patients had surgical intervention. Duration of albendazole therapy was (53.9±51.5) d. All patients were cured. Conclusions: Hydatid disease is uncommon in Qatar. It occurs mainly among non-Qataris from endemic areas and affects the liver mostly. Surgical intervention and albendazole administration are highly effective.

Epidemiology of hydatid disease in Qatar: a hospital based study from 2000 to 2013

OBJECTIVES@#To describe the epidemiological and clinical profile, treatment and outcome for hydatid diseases among the patients admitted to Hamad General Hospital.@*METHODS@#This retrospective study was carried out on patients admitted to Hamad General Hospital between 1st January 2000 and 31st December 2013. Descriptive statistics including range and percentage were used in analyzing the patient characteristics and laboratory parameters.@*RESULTS@#Hydatid disease was confirmed in 32 patients. The mean age of them was (35.59±13.00) years (range: 11-67 years) and 90.6% (29/32) of them were non-Qataris with male predominance. The main presenting symptom was abdominal pain 71.9% (23/32) followed by fever 45.9% (15/32). The main presenting sign was hepatomegaly 62.5% (20/32). Single organ involvement was found in 87.5% (28/32) and the common site involved was the liver 81.3% (26/32) followed by the lung 15.6% (5/32). The diagnosis was established by abdominal ultrasound and/or abdominal CT and confirmed by serology in all patients. The diagnosis was confirmed by histology in 90.6% (29/32) patients. All patients received albendazole, and 90.6% (29/32) patients had surgical intervention. Duration of albendazole therapy was (53.9±51.5) d. All patients were cured.@*CONCLUSIONS@#Hydatid disease is uncommon in Qatar. It occurs mainly among non-Qataris from endemic areas and affects the liver mostly. Surgical intervention and albendazole administration are highly effective.

GFR estimation in the morbidly obese pre- and postbariatric surgery: one size does not fit all.

BACKGROUND: Glomerular hyperfiltration commonly associated with obesity is expected to improve postbariatric surgery. However, formula-based glomerular filtration rate (GFR) estimation in these patients is limited by body size confounders necessitating use of modified equations, the reliability of which remains uncertain. METHODS: In this study, various GFR-estimating formulae were compared in morbidly obese patients at baseline and postbariatric surgery. Through a retrospective chart review, we identified 220 patients who had undergone this procedure, with over 6-month follow-up, during which major weight reduction was achieved. RESULTS: A significant decrease in BP and glomerular hyperfiltration was observed, though there was large variability in GFR estimation using the different formulae. Gross over and underestimation was observed which improved with correction for body size confounders especially lean body weight (LBW). Postoperatively, significant attenuation in estimated GFR was demonstrated when LBW or body surface area-adjusted versions were used. In a subgroup of patients with chronic kidney disease, a significant improvement in GFR was seen postoperatively with the LBW-modified formula but there were again inconsistencies when using other equations. CONCLUSION: Though clinicians must be critical in the application of GFR estimates to patient care, LBW adjustment appears to be the most practical solution to its estimation in the obese patients. This is particularly true for patients with normal renal function but appears to be also applicable to those with compromised kidney function. Future studies are needed to compare these equations with a gold standard GFR measure as well as to explore whether the renal benefits from bariatric surgery are sustained or seen in more advanced CKD stages.