Cardiovascular calcification in hemodialysis patients: A Qatar-based prevalence and risk factors study.

BACKGROUND: Patients with end-stage kidney disease on hemodialysis (HD) have an increased risk of death due to the high prevalence of cardiovascular disease. Vascular calcification (VC) is predictive of cardiovascular disease and mortality. We conducted a study to evaluate the prevalence and risk factors for VC in dialysis patients in Qatar. METHODS: This is a retrospective nationwide study including all chronic ambulatory dialysis patients in Qatar from 2020 to 2022. We used our national electronic medical record to track demographics, clinical characteristics, comorbidities, laboratory values, and diagnostic data for each patient. Calcifications were assessed by echocardiography (routinely done for all our dialysis population per national protocol), computed tomography, X-ray, and ultrasound. The study protocol was approved by the local medical research ethics committee (MRC-01-20-377). RESULTS: 842 HD patients were included in this study. Vascular calcifications (VC) were prevalent in 52.6% of patients. The main site of VC was Mitral valve calcifications in 55.5% of patients. Patients with VC were significantly older and had more prevalence of diabetes mellitus (p = 0.001 and p = 0.006, respectively). There was no statistically significant difference between patients with calcifications and patients without calcifications regarding serum calcium, phosphorus, and PTH level. In multivariate analysis, age and diabetes significantly increased the risk factor for calcification (95% CI 1.033-1.065, p < 0.0001, and 95% CI 1.128-2.272, p < 0001, respectively). Moreover, higher vitamin D levels and higher doses of IV Alfacalcidol were significant risk factors for calcifications (95% CI 1.005-1.030, p < 0.007, and 95% CI 1.092-1.270, p < 0.0001, respectively). CONCLUSION: Our study found that vascular calcification was widespread among our dialysis population in Qatar. Implementing the practice of echocardiography in dialysis patients was extremely helpful and the most productive in detecting vascular calcification. Diabetes mellitus almost doubles the risk for vascular calcifications in dialysis patients. These results are beneficial in identifying risk factors for vascular calcification, which can help stratify dialysis patients' risk of cardiovascular disease and optimize prevention efforts.

Comparison of high pressure and thermal pasteurization on the quality parameters of strawberry products: a review.

Strawberry (Fragaria ananassa) is rich in bioactive compounds with high antioxidant activity. High pressure processing (HPP) is an efficient alternative to preserve these bioactive compounds in terms of microbial inactivation and shelf-life stability. This review compares the effects of pasteurization methods using high pressure or thermal pasteurization (TP) on the quality parameters of various strawberry-based products. To summarize, most of the high pressure-treated products are microbiologically stable and showed minimum degradation of thermolabile compounds than TP-treated ones. However, some studies reported that high pressure did not have an advantage over TP especially in the preservation of phenolic phytochemicals during storage. The insufficient enzyme inactivation and high residual activity of enzymes after high pressure treatment could cause anthocyanins degradation thus affecting the product quality. Overall, this review could be valuable to potential processors in evaluating the effective commercialization of high pressure-treated strawberry products.

Stability Enhancement of Anthocyanins from Blackcurrant (Ribes Nigrum L.) Pomace through Intermolecular Copigmentation.

Intermolecular copigmentation denotes the interaction between colored anthocyanins and the colorless copigment, which is not bound covalently to the anthocyanin molecule. This is the first study to investigate the effect of intermolecular copigmentation on the stability of individual anthocyanins from dried blackcurrant pomace (DBP) using four pure phenolic acids as copigments (ferulic, caffeic, chlorogenic, and rosmarinic acid). Studies were performed at pH 3.0 and pH 6.0, with a copigment/anthocyanin extract molar ratio of 5:1, during storage at 20 °C. At both pH 3.0 and 6.0, rosmarinic acid showed the strongest hyperchromic and bathochromic effects (p < 0.05) on day 0. However, rosmarinic acid showed low stability during storage. At pH 3.0, chlorogenic acid and control samples were capable of maintaining very high levels of total anthocyanin stability during storage (p < 0.05). On the other hand, ferulic acid and control samples had the longest estimated half-life during storage at pH 6.0. Intermolecular copigmentation successfully increased the half-life, color retention, and antioxidant activity of the anthocyanin solution, with cyanidin-3-O-glucoside (C3G) exhibiting the highest stability at both pH values. Overall, anthocyanins from DBP, in combination with chlorogenic or ferulic acid, showed potential for use in commercial food applications.

Evaluating serum level of thymidylate synthase in post burn keloid patients before and after intralesional injection of 5-fluorouracil.

BACKGROUND: Keloids are fibrous lesions formed at the site of trauma due to types I and III collagen irregular production. The presence of thymidylate synthase (TS) is a must for DNA synthesis and repairs causing cell death. 5-fluorouracil (5-FU) is a fluorinated pyrimidine analogue acting as an anti-metabolic agent that inhibits thymidylate synthase and interferes with ribo-nucleic acid (RNA) synthesis. OBJECTIVES: we aimed to evaluate the level of thymidylate synthase in post burn keloid patients before and after intralesional injection of 5-fluorouracil. METHODS: The study included 20 keloid patients and 20 healthy subjects as a control. Serum TS was estimated using commercially available enzyme-linked immunosorbent assay (ELISA) kits before and after treatment with 5-fluorouracil. RESULTS: There was a statistically significant difference in TS levels before and after 5-FU treatment (p < 0.05). Also, results have shown that 5-FU injection has good satisfactory results in treatment of keloid causing reduction in scar volume and symptoms improvement (90% of the patients improved). On the other hand, there was no statistically significant difference in TS levels and the outcomes of the treatment. CONCLUSION: Our findings suggest that intralesional 5-FU injection in keloid has very satisfactory results. However, thymidylate synthase enzyme has a minimal role in evaluating the treatment of keloid, so further studies are required to elaborate the relation between this enzyme and keloid scars.

Optimization of the Drum Drying Parameters and Citric Acid Level to Produce Purple Sweet Potato (Ipomoea batatas L.) Powder Using Response Surface Methodology.

Purple sweet potato (PSP) is a rich source of anthocyanins, but the anthocyanin content and color can be affected by the drying method and processing condition. Response surface methodology (RSM) with a Box-Behnken design (BBD) was used to investigate the effects of citric acid (CA) concentration, steam pressure (SP) and rotation speed (DS) on the physicochemical and functional properties of drum-dried purple sweet potato powder (PSPP). The anthocyanins of the PSPP were analyzed using mass spectrometry with electrospray ionization and twelve anthocyanins were identified. The results indicated that the moisture content (4.80 ± 0.17-9.97 ± 0.03%) and water activity (0.290 ± 0.004-0.47 ± 0.001) (p < 0.05) decreased with increasing drum temperature as well as with reduced drum rotating speed. CA had a significant (p < 0.05) effect on the color and total anthocyanin content (101.83 ± 2.20-124.09 ± 2.89 mg/100 g) of the PSPP. High SP and low DS negatively affected the antioxidant properties of the PSPP. DPPH value of the PSPP ranged from 20.41 ± 0.79 to 30.79 ± 1.00 µmol TE/g. The optimal parameters were achieved at 0.59% CA, 499.8 kPa SP and 3 rpm DS.

Acetic acid buffer as extraction medium for free and bound phenolics from dried blackcurrant (Ribes nigrum L.) skins.

The aim of this study was to investigate the effects of different solvent and extraction temperatures on the free and bound phenolic compounds and antioxidant activity of dried blackcurrant skins (DBS). Apart from acetic acid buffer solution, different solvent systems, including water, methanol, and mixtures of methanol/water, were also employed and the effects of solvent and temperature (30 and 50 °C) on the free and bound forms of anthocyanins, hydroxycinnamic acids, and flavonols yield were assessed. The results showed that among all solvents, acetic acid buffer resulted in the highest free anthocyanin content (1,712.3 ± 56.1 mg/100 g) (P < 0.05) after 2 hr extraction at 50 °C from DBS, while lower amounts of bound anthocyanins and anthocyanidins were detected after acid hydrolysis. Acetic acid buffer extracts exhibited the highest free hydroxycinnamic acid content (268.0 ± 4.5 mg/100 g), total phenolic content (3702.2 ± 259.3 mg GAE/100 g), and DPPH activity (60.7 ± 2.0% of inhibition). However, their free flavonol content was slightly lower (60.2 ± 0.8 mg/100 g) compared to 100% methanol at 30 and 50 °C (71.4 ± 1.5 mg/100 g and 71.5 ± 6.2 mg/100 g, respectively). Two-way ANOVA indicated interactions between solvent and temperature (P < 0.05), which suggested that the relationship between solvent and phenolic compounds depends on the extraction temperature. PRACTICAL APPLICATION: Overall, acetic acid buffer is more environmental friendly, efficient, and cost effective than other solvents, thus, offering an improved extraction method for phytochemicals as valuable ingredients for nutraceutical applications, from underutilized dried blackcurrant skins (DBS).

Rhabdomyosarcoma in childhood: a retrospective analysis of 190 patients treated at a single institution.

OBJECTIVES: The study goal was to retrospectively review the treatment results of childhood rhabdomyosarcoma and identify prognostic factors that affect treatment outcome. PATIENTS AND METHODS: The records of 190 patients with childhood rhabdomyosarcoma treated between January 1991 and December 1999 were reviewed. The data were analyzed for clinico-epidemiological factors and the impact of potential prognostic factors on failure-free survival. Factors evaluated were age, gender, histology type, primary site, tumor size, Intergroup Rhabdomyosarcoma Study (IRS) group, surgical procedure, and the use of radiation treatment. RESULTS: The 5-year actuarial FFS and OS were 40% and 50%, respectively. The only significant prognostic factors as estimated by univariate analysis were histology type (p=0.01), primary site (p=0.002), tumor size (p=0.049), IRS-group (p=0.003), surgical procedure (p=0.002), and radiation treatment (p=0.001). Multivariate analysis showed that histology type (p=0.02), primary site, and IRS-group (p=0.02) were the only independent prognostic factors. CONCLUSIONS: This analysis demonstrates that failure-free survival for rhabdomyosarcoma is dependent on several factors at the time of initial diagnosis, including histologic subtype, primary site and disease group. Our treatment results were inferior compared to IRS-studies as the patients during this period were treated on individual bases and not standardized protocol.

A randomized study of accelerated fractionation radiotherapy with and without mitomycin C in the treatment of locally advanced head and neck cancer.

OBJECTIVES: This single-institution study evaluates the feasibility of accelerated fractionation radiotherapy (AF) with and without mitomycin C (MMC) in the treatment of locally advanced head and neck cancer. PATIENTS AND METHODS: Between May 1998 and October 2001, sixty patients with locally advanced stage III and IV of head and neck cancer were randomized into three treatment arms: (1) conventional fractionation radiotherapy (CF) (5 fractions per week); (2) accelerated fractionation radiotherapy (AF) (6 fractions per week); and (3) AF plus Mitomycin C (MMC). RESULTS: The 2-year overall survival (OS) of the whole group was 21%. The OS according to treatment arm was 23%, 20%, and 28% in CF, AF, and AF+MMC arms respectively (p<0.19). The 2-year loco-regional control (LC) rate was 22% for the whole group of patients. The LC was 10%, 25%, and 30% for the CF, AF, and AF+MMC respectively (p=0.27). The only significant parameters for OS and LC were performance status and pre-treatment hemoglobin level. Mucositis grades 3 & 4 occurred in 70% and 90% of the patients in the AF and AF+MMC arm respectively compared to 55% of patients in the CF arm (p=0.04). However the addition of MMC did not significantly increase the incidence or severity of mucositis between AF and AF+MMC (p=0.13). Hematological toxicity grades 3 & 4 were significantly higher after MMC (occurred in 40% of patients versus 10% and 5% in CF and AF arms respectively, p=0.04). There was no statistically significant difference in the incidence of grade 3 dryness of mouth (p=0.06), fibrosis (p=0.6), or lymphoedema (p=0.39) among the three arms. CONCLUSION: There was a trend for improvement of LC and OS rates with the use of AF and the addition of MMC to AF compared to CF radiotherapy, although the difference was not statistically significant. The small number of the patients in each treatment arm and the inclusion of multiple tumor sites may contribute to these statistically insignificant results. Accordingly we advise 85 to continue the trial with inclusion of a larger number of patients and restrict tumor sites to one major site.