A population-based study of 15,000 people on Knowledge and awareness of lung cancer symptoms and risk factors in Saudi Arabia.

Background: Lung cancer is currently the most fatal form of cancer worldwide, ranking as the fourth most prevalent type in Saudi Arabia, particularly among males. This trend is expected to increase with growing population, lifestyle changes, and aging population. Understanding the awareness of the Saudi population regarding the risk factors and symptoms of lung cancer is necessary to attenuate the predicted increase in cases. Method: A cross-sectional, population-based survey was performed using a previously validated questionnaire (Lung CAM). Multiple linear regression analysis was used to assess variables associated with deficiency in knowledge and awareness of risk factors and symptoms of lung cancer. Results: Majority of the 15,099 respondents were male (65%), aged between 18 and 30 years (53%), 50% of which were educated up to a bachelor's degree level. Overall awareness of lung cancer signs and symptoms was 53%, with painful cough and coughing up blood being the best-known symptoms. Conversely, persistent shoulder pain (44%) and clubbing fingers (47%) were the least known lung cancer symptoms. Also, 60% of the respondents showed low confidence in identifying the signs and symptoms of lung cancer. The overall awareness of the risk factors for lung cancer development was 74%, with first-hand (74%) and second-hand (68%) smoking being the most known risk factors. However, only ≤ 62% know the other non-smoking risk factors. Awareness of the risk factors and symptoms of lung cancer depended on age, gender, education, marital and employment status (p < 0.001). Conclusion: Public awareness of the risk factors and symptoms of lung cancer in Saudi Arabia is inadequate and heavily dependent on education and socio-economic status. Awareness can be improved through campaigns to raise awareness about other lesser-known lung cancer risk factors and symptoms.

Structural retrofitting of RC slabs using bamboo fibre laminate: Flexural performance and crack patterns.

Enhancing the durability of structural elements is a viable approach to promote sustainability in civil engineering. Research has shown that well-maintained slabs outperform degraded ones, which deteriorate rapidly due to insufficient upkeep. The occurrence of cracking and deformation in slabs subjected to sustained loads significantly impacts their functionality. However, the implementation of appropriate retrofitting techniques utilizing locally available materials can effectively minimize deflection and crack propagation while also improving flexural capacity. This particular study aimed to evaluate the flexural performance of slabs that were retrofitted using bamboo fibre laminate (BFL). Also, the study investigated two alternative replacement methods alongside the conventional mix; one involved replacing all fine aggregates with ceramic fine aggregate and the other involved a complete replacement of coarse aggregates with ceramic coarse aggregate. These mixes were represented in both the retrofitted and non-retrofitted samples. The retrofitting process included using the combined external bonding and near surface-mounted method. Twelve slab samples were made, with six being non-retrofitted and the other six retrofitted with BFL. Each of the samples had dimensions of 300 mm × 300 mm × 50 mm for reinforced concrete (RC) slabs. The slabs were tested employing the three point-bending system, and the retrofitted slabs with the conventional mix exhibited the highest ultimate failure load and flexural strength (62.1 kN), which compared to the non-retrofitted slabs of the same mix was a 60.76% increase. Additionally, the study did a thorough analysis of the presence of flexural and diagonal shear cracks, as well as the occurrence of debonding between BFL and the slabs. Non-destructive tests were also conducted on the slab samples to further confirm accurate results. These findings offer helpful insights into the development and application of a sustainable retrofitting material that can remarkably improve RC slabs.

Parents' knowledge regarding first-aid management of epistaxis in children in Taif, Saudi Arabia.

Objectives: Epistaxis among children is considered a scary issue for both the child and the parents. In Saudi Arabia, one third of children suffer from epistaxis. In our study, we aimed to assess the level of knowledge among parents regarding first-aid management of epistaxis in Taif city, Saudi Arabia. Method: We carried out a descriptive cross-sectional study among parents who visited Alhada Armed Forces Hospital and Prince Mansour Military Hospital between May 2022 and July 2022 in Taif, Saudi Arabia. A questionnaire with 17 questions was distributed among the participants. We excluded parents with children who were older than 18 years. Results: A total of 502 parents were included in the study. About two thirds (67.5%) of parents had a moderate level of knowledge and around one third (30.9%) showed a good level of knowledge regarding epistaxis first aid. Furthermore, higher knowledge scores were found among parents who had epistaxis previously (P = 0.026), who attended a course on first aid (P = 0.002), and who were aged more than 35 years (P = 0.017). Conclusion: Our study demonstrated that most Saudi parents had a moderate level of knowledge regarding first-aid management of epistaxis. Additionally, several factors, such as the number of children, age, those attending first-aid courses, and experience treating others with epistaxis, were associated with the level of knowledge among parents. Further larger studies are required among Saudi parents to examine the knowledge, practice, and related factors regarding first-aid management of epistaxis.

Intramuscular Versus Intravenous Treatment of Status Epilepticus: A Systematic Review.

Status epilepticus is a neurological emergency associated with high morbidity and mortality with fatal outcomes if not treated well. The goal of this study was to compare the intramuscular and intravenous treatment of individuals with status epilepticus. A search was performed on Scopus, PubMed, Embase, and Web of Science databases for articles published in the English language in peer-reviewed publications up to March 1, 2023. Studies were included if the treatment of status epileptics was compared either directly or indirectly between intramuscular and intravenous methods. In addition, relevant papers were manually screened for in the reference lists of the included studies. Non-duplicate articles were identified. Finally, five articles were included in the analysis, of which four were randomized controlled trials and one was a retrospective cohort study. The intramuscular midazolam group's time until the first seizure stopped was significantly shorter than the intravenous diazepam group's time (7.8 versus 11.2 minutes, respectively; p = 0.047). Moreover, the percentage of patients admitted was significantly lower in the intramuscular group than in the intravenous group (p = 0.01), but the lengths of stay in the intensive care unit and the hospital did not differ significantly between the groups. Regarding seizure recurrence, the intramuscular group had fewer incidences of recurrent seizures. Finally, there were no appreciable differences in safety outcomes between the two treatment arms. During the analysis, different outcomes reported after the use of intramuscular and intravenous treatments in managing patients with status epilepticus were categorized. This categorization led to a clear view of the efficacy and safety of intramuscular versus intravenous treatments in managing status epilepticus patients. The information at hand indicates that intramuscular therapy is just as successful as intravenous therapy in treating people with status epilepticus. The availability, adverse effect profile, logistics of administration, cost, and whether it is included in hospital formularies are some of the factors to be taken into consideration when choosing the drug administration technique.

An Assessment of Dementia Knowledge and Its Associated Factors Among Health College Students in Saudi Arabia.

Background Dementia is a public health concern and the main cause of impairment and dependency among the elderly worldwide. It is characterized by a progressive decline in cognition, memory, and all domains of quality of life with preserving the level of consciousness. Accurate measurement of dementia knowledge among future health professionals is required to improve targeted educational initiatives and supportive care of patients. This study aimed to assess knowledge of dementia and its associated factors among health college students in Saudi Arabia. Methods A descriptive, cross-sectional study was conducted among health college students from various regions in Saudi Arabia. Data on sociodemographic characteristics and dementia knowledge were gathered using a standardized study questionnaire Dementia Knowledge Assessment Scale (DKAS) distributed on different social media platforms. Data analysis was carried out using IBM SPSS Statistics for Windows, Version 24.0 (IBM Corp., Armonk, NY, USA) statistical software. A P-value of <0.05 was considered significant. Results A total of 1,613 participants were included in the study. The mean age was 20.5 ± 2.5 years (range 18-25 years). The majority of them were males (64.9%), and females represented 35.1%. The mean knowledge score of the participants was 13.68 ± 3.18 (out of 25). According to DKAS subscales, we found that the respondents scored the highest in care considerations (4.17 ± 1.30) and the lowest in risks and health promotion (2.89 ± 1.96). Furthermore, we found that the participants with no previous dementia exposure had a significantly higher level of knowledge than those with previous dementia exposure. In addition, we found that both genders, aged 19, 21, 22, 23, 24, and 25 years; the geographic distribution of respondents; and previous dementia exposure significantly affected the DKAS score. Conclusions Our findings showed that health college students in Saudi Arabia had poor knowledge about dementia. Ongoing health education and comprehensive academic training are recommended to improve their knowledge and provide competent care for dementia patients.

Prevalence and Risk Factors of Allergic Rhinitis Among the Population in the Makkah Region, Saudi Arabia: A Cross-Sectional Study.

Background Allergic rhinitis (AR) is considered a high global disease burden; hence, the shortage of knowledge would lead to poor adherence to management and preventive measures and increase the exacerbation of AR symptoms. This study aimed to evaluate the prevalence and risk factors, and assess the knowledge and practices of the population regarding AR among the population in Makkah city, Saudi Arabia. Methodology This was an online survey cross-sectional study conducted in December 2022 via social media platforms (WhatsApp and Twitter) to collect data on participants' demographics, prevalence, risk factors, knowledge, and attitudes toward AR, using a validated Arabic version of a self-administered questionnaire. Results The study involved 466 participants. Of the participants, 55.8% were aged 31 to 45 years, and 286 (61.4%) were females. The prevalence of AR among the participants was 45%. The most common symptoms were a blocked nose (79.6%), sneezing (74.2%), and a runny nose (71.5%). Furthermore, the prevalence of rhinoconjunctivitis in this study was 56%. The most common inhalant allergen was house dust (73.0%). Only the age and history of asthma or eczema were significant factors associated with AR. Overall, most of the subjects (94.85%) had adequate knowledge regarding AR. Conclusion A high prevalence of AR was observed. Understanding the factors linked with AR is imperative to ensure better adherence to preventive management plans.

Improving Stability of Flaxseed Oil by Rice Bran Oil as Source of γ-Oryzanol.

<b>Background and Objective:</b> Rice bran oil (RBO) and flaxseed oil (FSO) are vegetable oils that play an important role in human nutrition. RBO is very rich in γ-oryzanol, which is extracted from the inner husk and seed of the rice. γ-oryzanol is a mixture of natural antioxidant compounds in the RBO. Therefore, the current study aimed at the possibility of using rice bran oil (RBO) to improve the oxidative stability of virgin flaxseed oil (FSO) without synthetic antioxidants. <b>Materials and Methods:</b> Rice bran oil (RBO) has been added into FSO at 500, 1000 and 1500 ppm compared with FSO containing 200 ppm BHT as synthetic antioxidants. <b>Results:</b> The results showed that the use of RBO leads to an increase in the ability to resist against oxidation and it increases with the increase in the amount of RBO addition in the FSO samples, which recorded 7.36, 8.50 and 10.15 hrs for FSRB1, FSRB2 and FSRB3, respectively, while FSBHT (FSO sample contain BHT) recorded 8.40 hrs. <b>Conclusion:</b> The research recommended the addition of RBO as a source of γ-oryzanol to various foods increases the oxidative stability, increases the nutritional and health value of the food.

Chemical and Sensory Evaluation of Balady Bread Supplemented with Watermelon Rinds Flour and its Anti-Hyperlipidemic Effect in Male Albina Rats.

<b>Background and Objective:</b> Watermelon is a good source of minerals, vitamins and dietary fibers. It has been considered a health benefits effect due to the high amount of antioxidants and phytonutrients such as phenolics, flavonoids, phytosterols and other medicinal compounds which decrease the risk of cardiovascular, diabetes and cancer. This research was carried out to study the effect of wheat flour (WF) supplemented with different levels of watermelon rinds flour (WRF) on the chemical and organoleptic properties of balady bread. Furthermore, the effect of prepared bread on reducing blood lipids of hyperlipidemic rats. <b>Materials and Methods:</b> Wheat flour (WF) has been supplemented with different levels (5, 10, 15 and 20%) of watermelon rinds flour (WRF). The chemical and organoleptic properties of balady bread and the anti-hyperlipidemic effect of prepared bread on hyperlipidemic rats were evaluated. <b>Results:</b> The results indicated that incorporation of WRF in balady bread wheat flour increased the fibre, ash and minerals content of prepared bread. While carbohydrates content and energy value were decreased by increasing the WRF substitution levels. Organoleptic evaluation tests showed that up to 15% of WF could be replaced with WRF in balady bread and still more acceptable bread compared with control bread samples. In addition, rats fed on a hyperlipidemic diet containing balady bread fortified with WRF showed a significant decrease (p<0.05) in the triglyceride (TG), total cholesterol (TC), High-Density Lipoprotein Cholesterol (HDL-C), Low-Density Lipoprotein Cholesterol (LDL-C) and Very-Low-Density Lipoprotein Cholesterol (V-LDL) level by increasing the amounts of simultaneous supplementation with WRF 5-15% in the formulated balady bread compared to control samples. <b>Conclusion:</b> The research recommended that the 15% replacement of WRF gave good quality properties and lead to reducing body weight and serum lipid profile of hyperlipidemic rats.

The Role of Drilled Formation in Filter Cake Properties Utilizing Different Weighting Materials.

The filter cake formed during a filtration process plays a vital role in the success of a drilling operation. There are several factors affecting the filter cake build-up such as drilled formation, drilling fluid properties, and well pressure and temperature. The collective impact of these two factors (i.e., formation and the drilling fluid) on the filter cake build-up needs to be fully investigated. In this study, two types of formations represented as limestone and sandstone were used with different weighting materials to assess and compare their impact on the filter cake properties, filtration behavior, and solid invasion. The used weighting materials are manganese tetroxide, ilmenite, barite, and hematite. The filter cake was formed under a temperature of 200 °F and differential pressure of 300 psi. Nuclear magnetic resonance spectroscopy was employed to explore the pore structure of the used core samples. The results showed that the properties (i.e., shape and dimensions) of the different weighting materials are the dominant factors compared to the formation characteristics in most of the investigated filter cake properties. Nevertheless, the formation properties, namely, the permeability and pore structure, have a somehow higher contribution when it comes to the filter cake porosity and thickness. For solid invasion, there were no clear results about the main factor contributing to this issue.

Effect of Different Weighting Agents on Drilling Fluids and Filter Cake Properties in Sandstone Formations.

Weighting agents such as barite, micromax, ilmenite, and hematite are commonly added to drilling fluids to produce high-density fluids that could be used to drill deep oil and gas wells. Increasing the drilling fluid density leads to highly conspicuous fluctuation in the drilling fluid characteristics. In this study, the variation in the drilling fluid's rheological and filtration properties induced by adding different weighting agents was evaluated. For this purpose, several water-based drilling fluid samples were prepared and weighted up using the same concentration of various weighting materials including barite, micromax, ilmenite, and hematite. The characteristics of the used weighting agents' (particle size distribution and mineralogy) were measured. Subsequently, the rheological properties of the drilling fluid were obtained using a Fann viscometer at 80 °F. The filtration test was carried out at 200 °F and 300 psi differential pressure to form a filter cake over the sandstone core samples. The properties of the formed filter cake layer such as thickness, porosity, and permeability were determined. Furthermore, the typical properties of core samples including porosity and permeability were assessed before and after the filtration test. The displayed results confirmed that the plastic viscosity (PV), yield point (YP), and filter cake sealing properties were all significantly influenced by the ratio of the large to fine particle size (D90/D10) of the weighting agents irrespective of the weighting material type. Among the examined weighting agents, barite showed novel potency to control both rheological and filter cake properties for 14 ppg drilling fluid. The results showed that D90/D10 is a key factor for the PV and YP properties as increasing the D90/D10 ratio caused PV increase and YP decrease, which indicated that the interaction among the loaded weighting materials in the drilling fluid dominated its viscosity.

Effect of Perlite Particles on Barite Cement Properties.

Conventional heavy-weight oil and gas well cement systems formulated with barite exhibit high viscosities. Additionally, the heavy-weight powder tends to settle, causing density variation and disruption in the porosity of the hardened cement cores. Studies have shown that such problems can be mitigated by controlling the particle size distribution of the cement system. The main objective of this study is to evaluate the effect of perlite powder particles on the fluid and hardened properties of barite-based cement systems. Barite heavy-weight cement slurries containing 0, 1, 2, and 3% by weight of dry cement (BWOC) of perlite powder were prepared. The rheological study was performed at a bottomhole circulating temperature (BHCT) of 150 °F and ambient pressure. An ultrasonic cement analyzer (UCA) and a high-temperature-high-pressure (HTHP) curing chamber were used to cure samples for 24 h at a bottomhole static temperature (BHST) of 292 °F and pressure of 3000 psi. Porosity measurements were performed using the nuclear magnetic resonance (NMR) technique. The results indicate that the incorporation of perlite powder into conventional barite-based heavy-weight cement slurry causes modifications in the properties of the systems. In general, the plastic viscosity decreases, while the yield point and gel strength increase with increasing perlite concentration. The reduction in plastic viscosity also reduces the pump pressure, while the increase in yield point and gel strength reduces particle sedimentation. Additionally, the compressive strength and tensile strength of hardened cement increase, while the wait-on-cement time decreases. NMR studies indicate that perlite reduces the porosity variation that exists in conventional barite-based cement systems due to the formation of stable cement systems.

Investigating the Alteration of Sandstone Pore System and Rock Features by Role of Weighting Materials.

Drilled formations are commonly invaded by drilling fluids during the drilling operations, and as a result, the rock pore system will have alterations that consequently alter the rock properties. The objective of this study is to investigate the impact of the most commonly used weighting materials in water-based mud (WBM) on the Berea Buff sandstone pore system and rock characteristics. Rock-mud interaction was imposed by using a customized high-pressure high-temperature filtration test cell under 300 psi differential pressure and 200 °F temperature to simulate downhole conditions during drilling that affect the rock-mud interaction. Extensive lab analysis was accomplished to investigate the rock characteristic alterations in terms of rock porosity, permeability, pore size distribution, flow characteristics, resistivity, and acoustic properties. Ilmenite-WBM showed the maximum values (8.3 cm3 filtrate volume and 7.6 mm cake thickness), while barite recorded the lowest filtrate volume (5.3 cm3) and thickness (3 mm). Nuclear magnetic resonance profiles illustrated the changes in the rock pore system due to the dominant precipitation or dissolution effects. A general porosity reduction was recorded with all mud types that ranged from 4.2 to 9.9% for ilmenite and Micromax, respectively. The rock permeability showed severe damage after mud exposure and a reduction in the pore throat radius. After mud invasion, the rock electrical resistivity showed alterations based on the mineralogical composition of the weighting materials that replaced the saturated brine from the rock pores. Compressional wave velocities (V p) showed an increasing trend as V p of Micromax-WBM increased by 4.5%, while hematite- and ilmenite-WBMs recorded the minimum increase of 1.8%. A general reduction was found for shear wave velocities (V s); Micromax-WBM showed the highest V s reduction by 6.6%, while ilmenite-WBM recorded the minimum reduction of 1.8%. The pore system alterations are the main reason behind V p increase, where the rock lithology alterations controlled the V s changes. The study findings will add more for the rock logging interpretation and rock properties alterations after the mud exposure.

Complex barite filter cake removal using in-situ generated acids by thermochemicals.

In sandstone formations, the quartz particles integrate with drilling fluid solids and become part of the filter cake structure. As a result, the dissolution rate of the filter cake diminishes and reduces the removal efficiency. This paper presents a novel solution to overcome the challenges that restricts the filter cake removal process such as the presence of the quartz layer and the polymer coat. A multi-stage method for removing the filter cake from a wellbore is presented. The composition of the new formulation is; ammonium fluoride (NH4F), with a strong oxidizer, such as sodium bromate (NaBrO3) causes an exothermic reaction in the first stage, thereby removing the quartz layer and polymer coat in the filter cake by the in-situ generated HF acid. During the second stage for the barite-based filter cake, chelating agents combined with convertor catalysts were used to dissolve the barite. Solubility experiments were conducted to evaluate the efficiency at each stage in the filter cake removal process at 300 ºF and 500 psi. The experimental results showed that the formulation consisting of ammonium fluoride (NH4F), with a strong oxidizer (sodium bromate,NaBrO3), combined with exothermic reaction was able to generate HF in-situ, which in turn dissolved the quartz mineral and remove the polymer from the filter cake.

Risk Factors and Predictors of Severe Dengue in Saudi Population in Jeddah, Western Saudi Arabia: A Retrospective Study.

This study was performed to determine the risk factors and predictors of severe dengue fever (SDF) in Saudi population in Jeddah, Western Saudi Arabia. This 7-year retrospective study included children and adults with confirmed dengue from 2010 to 2016. Demographic, clinical, laboratory, serological, and virologic data were collected. Comparative analyses were performed between pediatric and adult SDF cases defined according to the WHO 2009 dengue classification. During the study period, dengue was confirmed in 17,646 cases with predominant infection of adults (6.5 times that of children) and males (3.8 times that of females). May and June were associated with 43.9% of total dengue cases. All 56 pediatric and 187 adult SDF cases were hospitalized. At least one warning sign of severe illness was present in 92.2% of total SDF cases. Mortality rates were 8.9% and 10.7% of pediatric and adult SDF cases, respectively. Multiple logistic regression detected that the most significant risk factors and predictors of SDF in adults versus children were significantly more secondary dengue infection (adjusted odds ratio [AOR]: 2.20, 95% CI: 1.09-4.44, P = 0.02), significantly less clinical fluid accumulation (AOR: 0.17, 95% CI: 0.07-0.44, P < 0.001) and significantly less neutropenia (AOR: 0.41, 95% CI: 0.17-0.97, P = 0.04). This was the first large multicenter study evaluating SDF in Saudi population and considering the WHO 2009 dengue classification, which showed predominant infection of adults and males with dengue, few SDF cases with low mortality and highlighted predictors of SDF in adults versus children. Consideration of warning signs for severe dengue may result in hospital admission, prompting closer monitoring, timely and proper interventions and reduced mortality in SDF cases.

Impact of the rise of artificial intelligence in radiology: What do radiologists think?

PURPOSE: The purpose of this study was to assess the perception, knowledge, wishes and expectations of a sample of French radiologists towards the rise of artificial intelligence (AI) in radiology. MATERIAL AND METHOD: A general data protection regulation-compliant electronic survey was sent by e-mail to the 617 radiologists registered in the French departments of Nord and Pas-de-Calais (93 radiology residents and 524 senior radiologists), from both public and private institutions. The survey included 42 questions focusing on AI in radiology, and data were collected between January 16th and January 31st, 2019. The answers were analyzed together by a senior radiologist and a radiology resident. RESULTS: A total of 70 radiology residents and 200 senior radiologists participated to the survey, which corresponded to a response rate of 43.8% (270/617). One hundred ninety-eight radiologists (198/270; 73.3%) estimated they had received insufficient previous information on AI. Two hundred and fifty-five respondents (255/270; 94.4%) would consider attending a generic continuous medical education in this field and 187 (187/270; 69.3%) a technically advanced training on AI. Two hundred and fourteen respondents (214/270; 79.3%) thought that AI will have a positive impact on their future practice. The highest expectations were the lowering of imaging-related medical errors (219/270; 81%), followed by the lowering of the interpretation time of each examination (201/270; 74.4%) and the increase in the time spent with patients (141/270; 52.2%). CONCLUSION: While respondents had the feeling of receiving insufficient previous information on AI, they are willing to improve their knowledge and technical skills on this field. They share an optimistic view and think that AI will have a positive impact on their future practice. A lower risk of imaging-related medical errors and an increase in the time spent with patients are among their main expectations.

Uptake of influenza vaccination, awareness and its associated barriers among medical students of a University Hospital in Central Saudi Arabia.

Outbreaks of influenza epidemics are common but influenza vaccination is sub-optimal among the healthcare staff including the medical students. The study aims to assess the rate of vaccine uptake among medical students, its associated barriers and levels of awareness. A cross sectional study was done at a University Hospital in Saudi Arabia on 421 medical students by self administered questionnaire from February to March 2015. The immunization rate of seasonal influenza vaccine was just 20.7% in 2015, while it was 57% for cumulative of previous three-year period. The intended uptake among those offered vaccination was 68%. The significant determinants of vaccine uptake were clinical years of medical study (p<0.05) and previous history of vaccination (p<0.0001). The major sources influencing vaccine uptake decision were health department guidelines, medical training, social and media influence. Barriers of vaccination constituted, assumption of not being at risk of influenza (37.9%), vaccine side effects (28.9%), questioned effectiveness of the vaccine (14.5%), and inability to allocate time (11%). Knowledge levels were unsatisfactory and males scored lower (5.4±1.7) than females (6.5±1.4) out of total score of 9. Both knowledge and uptake of annual influenza vaccination was inadequate. Policy makers can formulate strategies with a focus on larger coverage of medical students.

Streptococcus pneumoniae carriage among healthy and sick pediatric patients before the generalized implementation of the 13-valent pneumococcal vaccine in Morocco from 2010 to 2011.

Nasopharyngeal carriage studies provide insights into the local prevalence of circulating pneumococcal serotypes. These data are critical to vaccination monitoring, as they allow for the prediction and assessment of impact. Very little data are available on the carriage of pneumococcal serotypes in Morocco. Here, we describe the prevalence of Streptococcus pneumoniae carriage and serotype distribution among 697 pediatric patients with ages ranging from 2 to 59 months who were admitted to a Moroccan hospital with severe pneumonia, as well as 195 healthy infants and young children who were recruited at a vaccination clinic. Carriage rates were 40.5% (79/195) for healthy children and 22.8% (159/697) for sick children. The most commonly observed circulating serotypes included 6A, 6B and 19F, all of which are included in the current 13-valent anti-pneumococcal conjugate vaccine that was recently introduced in Morocco. Monitoring of circulating serotypes remains necessary after vaccine introduction to assess whether serotype replacement is occurring.

Dual-energy contrast-enhanced digital mammography in routine clinical practice in 2013.

To date, analysis of the vascularisation of breast lesions mainly relies on MR imaging. However, the accessibility of MRI is sometimes limited and has led to the development of new means of imaging, such as dual-energy contrast-enhanced mammography, which provides data on the vascularisation of the breast along with the usual morphological information. The purpose of this paper is to present this new imaging technique as well as the recent references, illustrated by clinical reports derived from our everyday practice to focus on the advantages and disadvantages of this new breast exploration. Dual-energy contrast-enhanced mammography is a recent, seemingly promising technique, in the management of breast cancer. The main advantages consist of its easy installation, the good tolerance and the comfort in the interpretation of difficult to read mammograms. However, the indications and the role of dual-energy contrast-enhanced mammography still have to be determined within the diagnostic strategy of breast tumours. New studies are expected, especially to compare dual-energy contrast-enhanced mammography with breast MRI.

Utility of serum preoperative carcinoemberyonic antigen in colorectal cancer patients.

BACKGROUND/AIMS: The usefulness of preoperative CEA in CRC remains controversial as regards its biological function, and its use in the diagnosis, prognosis, and management and follow up of CRC patients. the aim of this study was to provide a critical and updated study for the value of CEA in CRC. METHODOLOGY: From January 2000 to June 2005, a prospective randomized study involving 200 CRC patients for whom curative resection was performed, another 100 healthy persons as a control group was included. Basal CEA using chemilumescence technique and routine follow up were done. RESULTS: (1) The mean basal CEA in CRC patients (17.3 ng% +/- 1.67) was significantly higher than control (3.41 ng% +/- 1.1). (2) A significant linear association between basal CEA and Dukes' classes was evident with the mean basal CEA for Dukes' A, B, C were 7.8, 12.7, 25.8 respectively (expressed as ng%). (3) The validity of basal CEA in primary CRC diagnosis was highly positive (sensitivity 80%--PPV 86.95%--accuracy 73.66%), with hig her efficacy in advanced disease detection (sensitivity 93%--NPV 7%--accuracy 84.5%--odds ratio 30.3) and negative exclusion power for DFS prediction (specificity 13.84%). (4) The basal CEA was a discriminate factor in colorectal prognosis - B value (3.74). (5) Patients with CEA < or =5 ng% had better DFS (15%) and DFT (23.6 months) than those with CEA > 5 ng% as they had DFS (33.75%) and DFT (18.48 months). (6) Basal CEA above 15 ng% had a significant shift in the cumulative hazard of recurrence. CONCLUSION: The CEA is a metastasis potentiator. The high serum CEA in CRC screening programs should be considered a marker of malignancy especially in patients with appropriate symptoms. The preop CEA in CRC patients identifies subsets with favorable, indolent and uneven biological behavior (< or =5 ng%, < or =15 ng%, > 15 ng% respectively). Moreover, the addition of preop CEA level to conventional staging forms a strong prognostic tool and supplies adopted practice guideline initiative for follow up and therapy in CRC.