Duration and aetiology of extended hospitalization among COVID-19 patients in United Arab Emirates.

Background: A retrospective review of the early stages of the COVID-19 pandemic in 2020 and the challenges faced by hospitals is essential in the post-pandemic era of 2022. Aim: To identify the reasons for prolonged hospitalization after recovery for COVID-19 patients in the United Arab Emirates. Methods: This was a retrospective observational study of 150 (18.75%) patients with prolonged hospitalization in a tertiary hospital in Dubai from 1 April to 1 July 2020. Data was obtained from the electronic medical records of the hospital. Continuous variables are reported as mean and standard deviation, and categorical variables are reported as numbers and percentages. Results: The mean duration of hospitalization was 48.5 (9-272) days, with an interquartile range (IQR) of 22 days. The mean duration of extended stay was 27.5 (2-231) days, with an IQR of 17 days. The common reasons for prolonged hospitalization were mandatory isolation 28% (n = 62), hospital-acquired infections 17% (n = 37), acute respiratory distress syndrome 15% (n = 32), myopathy/neuropathy 14% (n = 31), pulmonary fibrosis requiring oxygen supplementation 14% (n = 31), and completion of COVID-19 treatment 12% (n = 25). Conclusion: To make optimal use of available hospital resources, reasons that directly or indirectly contributed to the prolonged hospitalization of patients should be considered and addressed during future pandemics or disease outbreaks.

Treatment of bronchial anastomotic fistula using autologous platelet-rich plasma post lung transplantation.

BACKGROUND: Bronchial anastomotic dehiscence is considered one of the most catastrophic early airway complications post-transplant. The presence of a partial dehiscence can also cause further complications such as a fistula between the bronchus and the pleural membrane. Platelet-rich plasma (PRP) is known to significantly enhance the healing process and is being used in the treatment of various conditions, however, so far, there are no reports of the use of PRP in the treatment of bronchial anastomotic dehiscence fistula. CASE PRESENTATION: We present a 37-year-old male, with non-cystic fibrosis bronchiectasis underwent bilateral lung transplantation. The patient developed partial dehiscence of the right bronchial anastomosis that was complicated by a small bronchopleural fistula. Two bronchoscopic applications of autologous platelet-rich plasma were carried out. Follow-up a few weeks later showed complete closure and healing of the fistula. CONCLUSIONS: This case report suggests that the treatment of post-lung transplant small bronchial anastomotic partial dehiscence fistula with PRP is safe and effective.

Transient Cell Cycle Induction in Cardiomyocytes to Treat Subacute Ischemic Heart Failure.

BACKGROUND: The regenerative capacity of the heart after myocardial infarction is limited. Our previous study showed that ectopic introduction of 4 cell cycle factors (4F; CDK1 [cyclin-dependent kinase 1], CDK4 [cyclin-dependent kinase 4], CCNB [cyclin B1], and CCND [cyclin D1]) promotes cardiomyocyte proliferation in 15% to 20% of infected cardiomyocytes in vitro and in vivo and improves cardiac function after myocardial infarction in mice. METHODS: Using temporal single-cell RNA sequencing, we aimed to identify the necessary reprogramming stages during the forced cardiomyocyte proliferation with 4F on a single cell basis. Using rat and pig models of ischemic heart failure, we aimed to start the first preclinical testing to introduce 4F gene therapy as a candidate for the treatment of ischemia-induced heart failure. RESULTS: Temporal bulk and single-cell RNA sequencing and further biochemical validations of mature human induced pluripotent stem cell-derived cardiomyocytes treated with either LacZ or 4F adenoviruses revealed full cell cycle reprogramming in 15% of the cardiomyocyte population at 48 hours after infection with 4F, which was associated mainly with sarcomere disassembly and metabolic reprogramming (n=3/time point/group). Transient overexpression of 4F, specifically in cardiomyocytes, was achieved using a polycistronic nonintegrating lentivirus (NIL) encoding 4F; each is driven by a TNNT2 (cardiac troponin T isoform 2) promoter (TNNT2-4Fpolycistronic-NIL). TNNT2-4Fpolycistronic-NIL or control virus was injected intramyocardially 1 week after myocardial infarction in rats (n=10/group) or pigs (n=6-7/group). Four weeks after injection, TNNT2-4Fpolycistronic-NIL-treated animals showed significant improvement in left ventricular ejection fraction and scar size compared with the control virus-treated animals. At 4 months after treatment, rats that received TNNT2-4Fpolycistronic-NIL still showed a sustained improvement in cardiac function and no obvious development of cardiac arrhythmias or systemic tumorigenesis (n=10/group). CONCLUSIONS: This study provides mechanistic insights into the process of forced cardiomyocyte proliferation and advances the clinical feasibility of this approach by minimizing the oncogenic potential of the cell cycle factors owing to the use of a novel transient and cardiomyocyte-specific viral construct.

Review of Nutrition Screening and Assessment Practices for Long-Term Care Residents.

The older adult population in Canada is growing, creating a greater demand for long-term care (LTC) facilities. Seniors living in LTC are more vulnerable to malnutrition, making it important to implement nutrition screening tools on a routine basis. The purpose of this study was to explore the practices of Registered Dietitians (RDs) related to nutritional screening, nutritional assessment, and follow-ups conducted within LTC facilities. This study also explored possible barriers hindering the application of these practices. Nine RDs from two health regions in Southern Saskatchewan completed a phone interview to address nutrition care practices/policies and barriers in LTC facilities. Results showed a considerable amount of variability in nutrition care practices for screening and assessment with lack of time identified as the greatest barrier. These findings highlight the importance of having consistent policies and a sufficient amount of RDs available in LTC facilities to provide the expected level of nutrition care for residents.

Catalytic Role of Thermostable Metalloproteases from Bacillus subtilis KT004404 as Dehairing and Destaining Agent.

Proteases with characteristic stabilities are considered attractive candidates for industrial catalysis. In the present study, a potent bacterial strain KT004404, an inhabitant of hydrothermal vents, was isolated and characterized for protease production. Initial screening indicated that this strain produced a hydrolytic zone of 30 mm 16S rRNA-based identification revealed that our isolate was a strain of Bacillus subtilis. Optimum reaction condition for maximum protease production was determined as 55 °C, pH 6, 1 % inoculum size and malt extract as primary growth substrate supplemented with 1 % dextrose. Yield of the enzyme was increased up to 7.53 folds with a specific activity of 55.125 U/mg after gel filtration chromatography. SDS-PAGE analysis confirmed the size of protease as 28.24 kDa. Purified enzyme retained its catalytic activity over a broad range of temperature (5 to 65 °C) and pH [5-8]. Addition of metal ions shown to have a stimulatory effect on catalytic properties while EDTA inhibited the efficiency of the enzyme confirming it as a metalloprotease. Protease exhibited excellent stability and activity in the presence of anionic surfactants, solvents, and detergents. The results of dehairing and destaining experiments suggested that the protease produced by B. subtilis KT004404 could be used in leather and textile industries with ecological benefits.

Prevalence of Type-2 diabetes in patients with hepatitis C and B virus infection in Jeddah, Saudi Arabia.

OBJECTIVES: To determine the prevalence of type-2 diabetes mellitus (DM) in patients with hepatitis C virus (HCV) and B virus (HBV) infections. MATERIALS AND METHODS: A cross-sectional study of HCV- and HBV-positive patients admitted to King Abdul Aziz University Hospital, Jeddah, Saudi Arabia, was conducted from January 1999 to September 2000. The following data were collected and analysed: demographic data, the presence and type of DM, details of the treatment, body mass index (BMI), family history of DM, serum transaminases, thrombocytopenia, and presence of liver cirrhosis on liver biopsy. A total of 399 patients were included in the study. RESULTS: 165 (41%) were anti-HCV positive and 234 (59%) were HBsAg positive. Type-2 diabetes was present in 35 of 165 (21.2%) patients with HCV infection, and 33 of 234 (14.1%) with HBV infection. 94% of anti-HCV-positive type-2 diabetes were older than 40 years and 6% were younger, while for nondiabetics the corresponding percentages were 55 and 45%, respectively. 76% of HBsAg-positive type-2 diabetics were older than 40 and 24% were younger, while the corresponding percentages for nondiabetics were 27 and 73%, respectively. Anti-HCV-positive type-2 diabetics, when compared to nondiabetics, had a higher BMI, a frequent family history of DM, elevated serum transminases, thrombocytopenia, and liver cirrhosis on biopsy. HBsAg-positive type-2 diabetics had only a more frequent family history of DM than did nondiabetics. CONCLUSION: Our findings indicate that type-2 diabetes is more common in patients with an HCV than with an HBV infection.

Low aspirin use in diabetics.

OBJECTIVE: To determine the percentage of adult diabetics with cardiovascular disease, or risk factors for cardiovascular disease who are using aspirin, and to report on any differences between males and females, or Saudis and non-Saudis. METHODS: Medical records of diabetics seen at King Abdulaziz University Hospital during the period January 1998 through to December 2000 were analyzed. The following data were collected: patients age, sex, nationality, body mass index, duration of diabetes, history of cardiovascular disease, risk factors for cardiovascular disease (hypertension, hyperlipidemia, obesity, smoking, family history of ischemic heart disease) and aspirin use. RESULTS: A total of 550 patients were studied with a mean age of 53 years and male: female ratio 1.1:1. Saudis constitute 260/550 (47%) of the study group. In patients with cardiovascular disease 110/174 (63%) were using aspirin versus 64/174 (37%) (p 0.001). In patients with one or more risk factors for cardiovascular disease but no cardiovascular disease, aspirin was used in 27/223 (12%) versus 195/223 (88%) (p 0.0001). Aspirin was used by 85/291 (29%) male versus 56/259 (22%) females (p 0.2). Sixty-three of 260 (24%) Saudis used aspirin versus 77/290 (27%) non-Saudis (p 0.7). CONCLUSION: Aspirin use is low in diabetics with cardiovascular disease and one or more risk factor of cardiovascular disease, with no significant difference between males and females, or Saudis and non-Saudis. Physicians should be encouraged to use aspirin more in diabetics for both primary and secondary prevention of cardiovascular disease.