The influence of papillary features on the risk of malignancy in thyroid nodules diagnosed as atypia of undetermined significance or follicular lesion of undetermined significance.

BACKGROUND: The objective of this study was to the assess the risk of malignancy in thyroid lesions that were diagnosed as AUS/FLUS when using a novel cytology subclassification system that is based on the presence or absence of papillary features. METHODS: AUS/FLUS case cytology was re-reviewed and subclassified into minor or major concern groups based upon the absence or presence of papillary features, respectively. The risk of malignancy (ROM) was calculated and compared between the two groups. Inter-pathologist agreement in case subclassification was also measured. RESULTS: The minor concern group had a 12.6% associated ROM, while the major concern group had a significantly higher ROM (58.4%), (P < 0.001). Based on 108 cases, the inter-pathologist agreement in case subclassification was 79%, and the κ value was 0.47. CONCLUSIONS: The identification of papillary features significantly increases the ROM in thyroid lesions with an AUS/FLUS diagnosis.

Echocardiographic and Clinical Correlates of Ejection Fraction Among 2000 Patients with Heart Failure in Western Saudi Arabia.

INTRODUCTION: Heart failure (HF) affects about 320,000 Saudi individuals and is associated with a considerable negative impact on the patients' quality of life. In literature, there is a lack of data about the echocardiographic abnormalities of HF patients in Saudi Arabia. AIM OF WORK: To describe the echocardiographic findings of HF patients in Western Saudi Arabia. METHODOLOGY: This was a retrospective record review study conducted on 2000 patients with chronic HF in Saudi Arabia. Demographic, clinical and echocardiographic data were collected and compared among patients with HF with reduced ejection fraction (HFrEF), ie, EF≤40%; HF with mid-range EF (HFmrEF), ie, EF=41-49%; and HF with preserved EF (HFpEF), ie, EF≥50%. RESULTS: Among the 2000 patients studied, females constituted 46.3% of the sample. About 52% of females had HFpEF, whilst 70% of males had HFrEF (p<0.0001). Diastolic dysfunction occurred in 98% of HFpEF versus 78% of HFrEF (p<0.0001). Patients with HFrEF had higher left-ventricular diastolic (LVd) volume (1536 versus 826), higher left-ventricular systolic (LVs) volume (1660 vs 772), higher left atrial volume (1344 vs 875), higher aortic root dimension (1144 vs 929) and lower fractional shortening (FS) (267 vs 1213) than patients with HFpEF (p<0.0001). CONCLUSION: HFpEF was more common among females and was associated with higher rates of diastolic dysfunction and higher FS. HFrEF was prevalent among males and associated with higher LVd, LVs, left atrium volume and aortic root dimensions.

Atrial fibrillation: risk factors and comorbidities in a tertiary center in Jeddah, Saudi Arabia.

INTRODUCTION: Atrial fibrillation (AF) is the most common type of cardiac arrhythmia worldwide and carries significant risk of morbidity and mortality. The prevalence of AF is high in significant parts of the world, but not much is known from countries, such as Saudi Arabia. AIMS: To study the risk factors, etiologies, comorbidities, and outcome of AF in Saudi Arabia. PATIENTS AND METHODS: A retrospective study was conducted in King Abdul-Aziz Hospital in Jeddah during the period 2010-2017. Data were collected from both the electronic-and paper-based medical records of patients with AF. The data included the demographic information, adverse lifestyle (smoking and obesity), cardiothoracic surgery, and comorbidities. RESULTS: A total of 167 patients were included in the analysis (43% were males). The mean age was 63.3±35 years and the mean body mass index was 28.8±83. Hypertension (HTN) was the most prevalent risk factor encountered (73.1%). This was followed by valvular heart disease, and type 2 diabetes mellitus (T2DM), which occurred in 58.7% and 53.3% of patients, respectively. Valvular heart disease was significantly associated with older age (P=0.002) and coronary artery disease (CAD) (P=0.001). Heart failure (HF) was associated with HTN (P=0.005), coronary heart disease (P=0.001), and chronic kidney disease (CKD) (P=0.003). CONCLUSION: AF was more prevalent among females in Saudi Arabia. HTN, valvular heart disease, and T2DM were the most prevalent risk factors of AF in Saudi Arabia. Valvular heart disease was more prevalent among older patients and significantly associated with CAD. HTN, CAD, and CKD were the most significant risk factors for HF in patients with AF.

Recognition of familiar people with a mobile cloud architecture for Alzheimer patients.

PURPOSE: This article aims to the evaluation of a prototypal assistive technology for Alzheimer's disease (AD) patients that helps them to remember personal details of familiar people they meet in their daily lives. METHOD: An architecture is proposed for a personal information system powered by face recognition, where the main AD patient's interaction is performed in a smart watch device and the face recognition is carried out on the Cloud. A prototype was developed to perform some tests in a real-life scenario. RESULTS: The prototype showed correct results as a personal information system based on face recognition. However, usability flaws were identified in the interaction with the smart watch. CONCLUSIONS: Our architecture showed correct performance and we realized that it could be introduced in other fields, apart from assistive technology. However, when being targeted to patients with dementia some usability problems appeared, such as difficulties to read information in a small screen or take a proper photo. These problems should be addressed in further research. Implications for Rehabilitation This article presents a prototypal assistive technology for Alzheimer's disease (AD) patients. It targets AD patients to recognize their familiars, especially in medium-advanced stages of the disease. Analysing pictures taken by a smart watch, which the patient carries, the person in front is recognized and information about him is sent to the watch. This technology enables patients to have all the information of any close person, as a remainder, easing their daily lives, improving their self-esteem and stimulating the patient with novel technology.

Bacterial contamination of cell phones of medical students at King Abdulaziz University, Jeddah, Saudi Arabia.

Cell phones are commonly used in healthcare settings for rapid communication within hospitals. Concerns have been increased about the use of these devices in hospitals, as they can be used everywhere, even in toilets. Therefore, they can be vehicles for transmitting pathogens to patients. This study aimed to examine the presence of pathogenic bacteria on the surfaces of cell phones that are used frequently by preclinical medical students. This cross-sectional study identified both pathogenic and nonpathogenic bacteria on cell phones of 105 medical students at King Abdulaziz University, Jeddah, Saudi Arabia, using standard microbiological methods. Out of 105 cell phones screened, 101 (96.2%) were contaminated with bacteria. Coagulase-negative staphylococci were the most abundant isolates (68%). Seventeen (16.2%) cell phones were found to harbor Staphylococcus aureus. Gram-positive bacilli were isolated from 20 (19%) samples. Viridans streptococci and Pantoea species were also isolated but at lower levels. Our findings indicate that cell phones can act as reservoirs of both pathogenic and nonpathogenic organisms. Therefore, full guidelines about restricting the use of cell phones in clinical environments, hand hygiene, and frequent decontamination of mobile devices are recommended at an early stage in medical schools, to limit the risk of cross-contamination and healthcare-associated infections caused by cell phones.