Annals of Saudi Medicine最新文献

{"title":"Effectiveness of granulocyte colony-stimulating factor for patients with acute-on-chronic liver failure: a meta-analysis.","authors":"Wei Huang,&nbsp;Yuanji Ma,&nbsp;Lingyao Du,&nbsp;Shuang Kang,&nbsp;Chang-Hai Liu,&nbsp;Lang Bai,&nbsp;Xuezhong Lei,&nbsp;Hong Tang","doi":"10.5144/0256-4947.2021.383","DOIUrl":"https://doi.org/10.5144/0256-4947.2021.383","url":null,"abstract":"<p><strong>Background: </strong>The safety and efficacy of granulocyte colony-stimulating factor (G-CSF) for the treatment of acute-on-chronic liver failure (ACLF) remain uncertain. Therefore, we conducted a meta-analysis to draw a firmer conclusion.</p><p><strong>Methods: </strong>We searched the Cochrane library, PubMed, Embase, and China Biology Medicine disc to identify relevant RCTs performed before January 2020. Risk ratios (RRs) and their 95% confidence intervals (95% CIs) were calculated using a random effects model.</p><p><strong>Main outcome measures: </strong>RRs (95% CI) for 1-, 2-, and 3-month survival rates.</p><p><strong>Sample size: </strong>Six RCTs, including three open-label studies.</p><p><strong>Results: </strong>The six studies included 246 subjects (121 in a G-CSF group and 125 in a control group). G-CSF administration significantly improved the 1-, 2-, and 3-month survival rates in patients with ACLF. The pooled RRs (95% CI, P) were 0.43 (0.27-0.69, <i>P</i>=.0004), 0.44 (0.32-0.62, <i>P</i><.00001), and 0.39 (0.22-0.68, <i>P</i>=.0009), respectively.</p><p><strong>Conclusion: </strong>G-CSF may be beneficial and effective in the treatment of ACLF, but further studies are needed to verify this conclusion.</p><p><strong>Limitations: </strong>The sample size was small, and studies were restricted to countries in Asia.</p><p><strong>Prospero registration number: </strong>CRD42021225681 CONFLICT OF INTEREST: None.</p>","PeriodicalId":8016,"journal":{"name":"Annals of Saudi Medicine","volume":"41 6","pages":"383-391"},"PeriodicalIF":1.6,"publicationDate":"2021-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/9b/d5/0256-4947.2021.383.PMC8650600.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39700082","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Abdominal aorta measurements by a handheld ultrasound device compared with a conventional cart-based ultrasound machine.","authors":"Abdulrahman M Alfuraih,&nbsp;Abdulaziz I Alrashed,&nbsp;Saleh O Almazyad,&nbsp;Mohammed J Alsaadi","doi":"10.5144/0256-4947.2021.376","DOIUrl":"https://doi.org/10.5144/0256-4947.2021.376","url":null,"abstract":"<p><strong>Background: </strong>Ultraportable or pocket handheld ultrasound devices (HUD) may be useful for large-scale abdominal aortic aneurysm screening. However, the reproducibility of measurements has not been compared with conventional cart-based ultrasound machines.</p><p><strong>Objectives: </strong>Investigate the intra- and inter-operator reproducibility of a HUD compared with a conventional ultrasound machine for aortic screening.</p><p><strong>Design: </strong>Analytical, cross-sectional.</p><p><strong>Setting: </strong>Ultrasound department at a large tertiary care hospital in Riyadh.</p><p><strong>Patients and methods: </strong>Eligible male participants aged ≥60 years were invited to participate upon arriving for a non-vascular ultrasound appointment. Three repeated anteroposterior measurements of the transverse aorta were made at the proximal and distal locations for each machine before repeating the measurements on a subset of participants by a second blinded operator. Intraclass correlation coefficients (ICC) and the Bland-Altman method were used to analyze reproducibility.</p><p><strong>Main outcome measure: </strong>Inter-system and intra- and inter-operator ICCs.</p><p><strong>Sample size: </strong>114 males with repeated measurements by second operator on a subset of 35 participants.</p><p><strong>Results: </strong>The median age (interquartile range) of participants was 68 years (62-74 years). The intra- and inter-operator ICCs were all >0.800 showing almost perfect agreement except for the inter-operator reproducibility at the proximal location using a conventional machine (ICC= 0.583, <i>P</i>=.007) and the Butterfly device (ICC=0.467, <i>P</i>=.037). The inter-system ICCs (95% CI) were 0.818 (0.736-0.874) and 0.879 (0.799-0.924) at the proximal and distal locations, respectively. The mean difference in aortic measurement between the ultrasound systems was 0.3 mm (1.7%) in the proximal location and 0.6 mm (3.6%) in the distal location. In total, >91% of the difference in measurements between the machines was <3 mm. The mean scanning time was 4:16 minutes for the conventional system and 3:53 minutes for the HUD (<i>P</i>=.34).</p><p><strong>Conclusions: </strong>Abdominal aortic screening using a HUD was feasible and reliable compared with a conventional ultrasound machine. A pocket HUD should be considered for large-scale screening.</p><p><strong>Limitations: </strong>No cases of abdominal aortic aneurysm in the sample and lack of blinding.</p><p><strong>Conflict of interest: </strong>None.</p>","PeriodicalId":8016,"journal":{"name":"Annals of Saudi Medicine","volume":"41 6","pages":"376-382"},"PeriodicalIF":1.6,"publicationDate":"2021-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/23/97/0256-4947.2021.376.PMC8654105.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39702317","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Complications of intravascular intrauterine transfusion for Rh alloimmunization.","authors":"Asma Alkhaibary,&nbsp;Mohannad Ali,&nbsp;Maha Tulbah,&nbsp;Maha Al-Nemer,&nbsp;Rubina M Khan,&nbsp;Maisoon Al Mugbel,&nbsp;Nada Al Sahan,&nbsp;Marwah Mazen Hassounah,&nbsp;Waleed Alshammari,&nbsp;Wesam I Kurdi","doi":"10.5144/0256-4947.2021.313","DOIUrl":"https://doi.org/10.5144/0256-4947.2021.313","url":null,"abstract":"<p><strong>Background: </strong>Intravascular intrauterine transfusion (IUT) is considered a safe procedure, but complications still occur, including fatalities.</p><p><strong>Objective: </strong>Review the outcomes of Rh alloimmunization, including indications and possible complications.</p><p><strong>Design: </strong>Retrospective cohort (medical record review).</p><p><strong>Setting: </strong>Tertiary care center.</p><p><strong>Patients and methods: </strong>We retrieved the records for all mothers who had an IUT for Rh alloimmunization between January 2009 and August 2019. We collected data on complications, post-transfusion hemoglobin and antibody combinations.</p><p><strong>Main outcome measure: </strong>Complications of IUT.</p><p><strong>Sample size: </strong>119 mothers with 154 fetuses (154 different pregnancies).</p><p><strong>Results: </strong>The 154 fetuses had 560 intrauterine transfusions. The median pre-IUT hemoglobin was a median of 8.0 g/dL while the median post-IUT hemoglobin 16 g/dL. Immediate procedure-related complications included fetal bradycardia in 2.7%, significant bleeding from the cord puncture site (for more than 2 minutes in 0.9%), and contractions in 0.9%. Eight (5.2%) were delivered by cesarean delivery due to IUT-specific complications such as post-procedure fetal bradycardia. Intrauterine fetal death complicated 8.4% of the pregnancies (13 fetuses). Phototherapy was required in 76 (49.4%), postnatal blood transfusions in 17 (11%), and exchange transfusion in 11 (7.1%). Neonatal death occurred 8 (5.2%). Data were insufficient to assess associations of complications with antibody combinations.</p><p><strong>Conclusions: </strong>Intrauterine transfusion is an effective treatment with high survival rates (around 90% for cases of Rh alloimmunization).</p><p><strong>Limitations: </strong>Case series.</p><p><strong>Conflict of interest: </strong>None.</p>","PeriodicalId":8016,"journal":{"name":"Annals of Saudi Medicine","volume":"41 6","pages":"313-317"},"PeriodicalIF":1.6,"publicationDate":"2021-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/8d/ee/0256-4947.2021.313.PMC8650595.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39700085","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Conjunctivitis and other ocular findings in patients with COVID-19 infection.","authors":"Haider Aswad Layikh,&nbsp;Zainab Adel Hashim,&nbsp;Alyaa A Kadum","doi":"10.5144/0256-4947.2021.280","DOIUrl":"https://doi.org/10.5144/0256-4947.2021.280","url":null,"abstract":"<p><strong>Background: </strong>COVID-19 is an acute respiratory illness caused by a novel coronavirus (SARS-CoV-2). COVID-19 that might affect the eye in the form of conjunctivitis and other ocular features.</p><p><strong>Objectives: </strong>Assess the frequency and clinical profile of conjunctivitis and other ocular findings in Iraqi patients with confirmed COVID-19 infection.</p><p><strong>Design: </strong>Analytical cross-sectional study.</p><p><strong>Setting: </strong>Secondary care center.</p><p><strong>Patients and methods: </strong>This study involved patients diagnosed with SARS-CoV-2 viral infection of variable disease severity from June 2020 to December 2020. Ocular history and the severity of SARS-CoV-2 viral infection was assessed for all of the patients.</p><p><strong>Main outcome measures: </strong>Frequency of conjunctival inflammation and other ocular findings in patients with coronavirus infection.</p><p><strong>Sample size: </strong>186 patients.</p><p><strong>Results: </strong>The patients had a mean (standard deviation, range) age of 44.4 (18.8, 18-78) years. Conjunctivitis was present in 25 patients (13.4%). There was no significant association between prevalence of conjunctivitis and patient gender (<i>P</i>=.868). However, conjunctivitis was significantly associated with the severity of the disease (<i>P</i>=.018): the rate of conjunctivitis was significantly higher in cases with severe disease (28%) in comparison with those with mild to moderate clinical presentation (9.3%). The natural course of conjunctivitis seemed to be mild with no effect on visual acuity and no short-term complications.</p><p><strong>Conclusion: </strong>Conjunctivitis can occur in patients with SARS-CoV-2 viral infection, and could be a presenting sign. Conjunctivitis is more common in cases of severe COVID-19 infection and since it could be a presenting sign it might be of benefit in the early diagnosis and treatment of COVID-19.</p><p><strong>Limitation: </strong>Single-center study, safety limitations in the examination of the patients.</p><p><strong>Conflict of interest: </strong>None.</p>","PeriodicalId":8016,"journal":{"name":"Annals of Saudi Medicine","volume":"41 5","pages":"280-284"},"PeriodicalIF":1.6,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/07/dd/0256-4947.2021.280.PMC8497005.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39493651","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Splenic abscess as a possible sequela of COVID-19: a case series.","authors":"Noura AlZarooni,&nbsp;Abdulaziz AlBaroudi,&nbsp;Labib AlOzaibi,&nbsp;Osama AlZoabi","doi":"10.5144/0256-4947.2021.307","DOIUrl":"10.5144/0256-4947.2021.307","url":null,"abstract":"<p><p>Splenic abscess is an aggressive disease with a non-specific etiology and symptoms that are systemically detrimental. During the current COVID-19 pandemic, there has been a noted rise in the incidence of splenic abscesses. The aim of this article was to explore whether infection with the SARS-CoV-2 virus increases the risk of developing splenic abscesses. We reviewed three cases with SARS-CoV-2 infection who developed splenic abscess. The clinical characteristics, treatment course, management and outcome are reported. We perceived that hypercoagulability status, superimposing infections and immunosuppression were related to SARS-CoV-2 infection. These were common factors in these three observed cases of splenic abscess as a complication related to the new viral pandemic. SARS-CoV-2 infection might be a risk factor in development of splenic abscess. SIMILAR CASES PUBLISHED: To the best of our knowledge only one case similar to our case series was published.</p>","PeriodicalId":8016,"journal":{"name":"Annals of Saudi Medicine","volume":"41 5","pages":"307-311"},"PeriodicalIF":1.6,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/1d/3d/0256-4947.2021.307.PMC8497008.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39493650","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"<i>Cryptosporidium spp.</i> during chemotherapy: a cross-sectional study of 94 patients with malignant solid tumor.","authors":"Mehmet Karabey,&nbsp;Hüseyin Can,&nbsp;Tülay Öncü Öner,&nbsp;Mert Döşkaya,&nbsp;Sedef Erkunt Alak,&nbsp;Aysu Değirmenci Döşkaya,&nbsp;Muhammet Karakavuk,&nbsp;Ahmet Efe Köseoğlu,&nbsp;Cemal Ün,&nbsp;Adnan Yüksel Gürüz,&nbsp;Ahmet Alacacıoğlu,&nbsp;Bayram Pektaş,&nbsp;Aytül Gül,&nbsp;Selçuk Kaya,&nbsp;Ayşegül Aksoy Gökmen","doi":"10.5144/0256-4947.2021.293","DOIUrl":"https://doi.org/10.5144/0256-4947.2021.293","url":null,"abstract":"<p><strong>Background: </strong><i>Cryptosporidium spp</i>. is a protozoan parasite that infects many vertebrate animals, including humans. Since <i>Cryptosporidium spp</i>. can cause chronic life-threatening diarrhea and severe malabsorption in immunocompromised patients, we investigated the prevalence of this parasite among patients undergoing chemotherapy for malignant solid tumors.</p><p><strong>Objective: </strong>Investigate the prevalence of <i>Cryptosporidium spp</i>. in stool samples.</p><p><strong>Design: </strong>Cross-sectional.</p><p><strong>Setting: </strong>Tertiary care.</p><p><strong>Patients and methods: </strong>Stool samples were collected from adult patients with malignant solid tumors receiving chemotherapy and diarrhea. <i>Cryptosporidium spp</i>. prevalence was determined using Ziehl-Neelsen staining, ELISA, and real-time PCR targeting of the <i>COWP</i> gene.</p><p><strong>Main outcome measure: </strong>The prevalence of <i>Cryptosporidium spp</i>. in patients undergoing chemotherapy for malignant solid tumors.</p><p><strong>Sample size: </strong>94 RESULTS: The prevalence was 2.1% (2/94), 5.3% (5/94), and 5.3% (5/94) as detected by Ziehl-Neelsen staining, real-time PCR and ELISA, respectively. The prevalence reached 8.5% (8/94) using all results obtained from the three methods. Among eight positive stool samples, four were positive by at least two different methods (Ziehl-Neelsen staining-ELISA or ELISA-real-time PCR) whereas the remaining four were positive by either ELISA or real-time PCR.</p><p><strong>Conclusion: </strong>These findings show the risk of cryptosporidiosis in cancer patients and the necessity to use at least two diagnostic methods during the diagnosis of cryptosporidiosis to reach more accurate and trustworthy results.</p><p><strong>Limitations: </strong>Further studies with a larger sample size are recommended.</p><p><strong>Conflict of interest: </strong>None.</p>","PeriodicalId":8016,"journal":{"name":"Annals of Saudi Medicine","volume":"41 5","pages":"293-298"},"PeriodicalIF":1.6,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/da/30/0256-4947.2021.293.PMC8497003.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39493649","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Functional results and survivorship after medial unicompartmental knee arthroplasty: a single center experience from Saudi Arabia.","authors":"Ammar Qutub,&nbsp;Amjad Ghandurah,&nbsp;Adel Alzahrani,&nbsp;Ahmed Alghamdi,&nbsp;Talal M Bakhsh","doi":"10.5144/0256-4947.2021.299","DOIUrl":"https://doi.org/10.5144/0256-4947.2021.299","url":null,"abstract":"<p><strong>Background: </strong>Isolated involvement of the medial compartment of the knee in degenerative disease is encountered in about 25% of patients with gonarthrosis. We aim to show that in a well-selected group of such patients, medial unicompartmental knee arthroplasty (UKA) is a good option.</p><p><strong>Objectives: </strong>Review the functional outcomes of patients undergoing UKA and determine the long-term survivorship of the implants and complications of the procedure.</p><p><strong>Design: </strong>Analytical retrospective chart review.</p><p><strong>Setting: </strong>Academic tertiary care medical center and tertiary care private hospital in the western region of Saudi Arabia.</p><p><strong>Patients and methods: </strong>We selected patients who underwent medial UKAs by the same surgeon between December 1988 and December 2009. The life table approach and the Kaplan-Meier statistical method were used to estimate the survival rate (5-30 years) with revision as the endpoint. Functional outcome scores were determined according to the Knee Society Clinical Rating System.</p><p><strong>Main outcome measures: </strong>Change in performance scores for pain, walking, and range of movement. Survivorship of the implants with removal of the implant as the endpoint; post-operative complications.</p><p><strong>Sample size: </strong>218 implants on 142 patients.</p><p><strong>Results: </strong>The survival rate of UKA was 94.7% at 10 years (95% CI 0.906-0.970), 80.9% at 20 years (95%CI 0.724-0.871), and 77.8% at 30 years (95%CI 0.669-0.855). The average grand total functional score increased from 61 (maximum 200) at 0 months to above 150 at ≥6 months.</p><p><strong>Conclusion: </strong>UKA is a good option for isolated medial compartment gonarthrosis with excellent functional outcome and good survivorship in selected patients.</p><p><strong>Limitation: </strong>Single center experience, retrospective. We lost 6.0% of patients during follow-up. Comparison with other treatment modalities is based on literature review and not on our own data.</p><p><strong>Conflict of interest: </strong>None.</p>","PeriodicalId":8016,"journal":{"name":"Annals of Saudi Medicine","volume":"41 5","pages":"299-306"},"PeriodicalIF":1.6,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/4e/1c/0256-4947.2021.299.PMC8497006.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39493652","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The risk of tuberculosis infection in 410 Saudipatients receiving adalimumab therapy.","authors":"Abdullah Al-Sohaim,&nbsp;Abdullah Saleh Bawazir,&nbsp;Turki Al-Turki,&nbsp;Eiman Omar Alsafi,&nbsp;Abdullah Al-Roqy,&nbsp;Layla Layqah,&nbsp;Salim Alawi Baharoone","doi":"10.5144/0256-4947.2021.285","DOIUrl":"https://doi.org/10.5144/0256-4947.2021.285","url":null,"abstract":"<p><strong>Background: </strong>Adalimumab is a fully humanized monoclonal antibody inhibitor of tumor necrosis factor-a used to treat various autoimmune disorders. Adalimumab poses a risk for tuberculosis (TB) infection, especially in countries where TB is endemic.</p><p><strong>Objective: </strong>Determine the rate of TB infection after adalimumab therapy in Saudi Arabia.</p><p><strong>Design: </strong>Medical record review.</p><p><strong>Settings: </strong>Tertiary care center in Riyadh.</p><p><strong>Patients and methods: </strong>Demographic and clinical data were retrieved from the electronic healthcare records of all patients who received adalimumab treatment from 2015 to 2019.</p><p><strong>Main outcome measures: </strong>Occurrence of TB after adalimumab therapy.</p><p><strong>Sample size: </strong>410 patients (median ([QR] age, 37 [28], range 4-81 years), 40% males RESULTS: Rheumatoid arthritis was the most frequent indication (n=153, 37%). The patients were followed for a mean of 36 (8.9) months. No case of TB infection or reactivation was observed. An inter-feron-gamma release assay (IGRA) was requested in 353/391 (90.3%) patients, prior to initiating therapy. The IGRA was positive in 26 cases (6.6%). The IGRA-positive patients received isoniazid prophylactically. Bacterial infectious complications of adalimumab therapy occurred in 12 (2.9%) patients. Urinary tract infection was the most frequent complication (culture requested in 48 patients, positive in 8).</p><p><strong>Conclusion: </strong>Adalimumab treatment was not associated with a risk of TB disease or TB reactivation in our cohort over the follow-up observation period. No TB reactivation occurred with adalimumab therapy when TB prophylaxis was used. The positive IGRA rate in patients on adalimumab treatment was low (7%).</p><p><strong>Limitations: </strong>Single center and one geographical area in Saudi Arabia.</p><p><strong>Conflict of interest: </strong>None.</p>","PeriodicalId":8016,"journal":{"name":"Annals of Saudi Medicine","volume":"41 5","pages":"285-292"},"PeriodicalIF":1.6,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/e1/46/0256-4947.2021.285.PMC8497010.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39493653","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patients with hypertension hospitalized with COVID-19 pneumonia using angiotensinconverting enzyme inhibitors and angiotensin II receptor blockers or other antihypertensives: retrospective analysis of 435 patients.","authors":"Seyma Baslilar,&nbsp;Bengu Saylan","doi":"10.5144/0256-4947.2021.268","DOIUrl":"https://doi.org/10.5144/0256-4947.2021.268","url":null,"abstract":"<p><strong>Background: </strong>The angiotensin-converting enzyme inhibitors (ACEI) and angiotensin II receptor blockers (ARBs) are widely used for the treatment of hypertension (HT). Whether the use of these drugs increases the infectivity of novel coronavirus and results in an additional risk for morbidity and mortality of COVID-19 is a matter of interest.</p><p><strong>Objectives: </strong>Assess the effect of ACEI/ARBs compared with other hypertensives on the clinical course and outcome in COVID-19 pneumonia.</p><p><strong>Design: </strong>Retrospective.</p><p><strong>Settings: </strong>Tertiary care hospital.</p><p><strong>Patients and methods: </strong>We collected data on adult inpatients with COVID-19 pneumonia using ACEI/ARBs versus other antihypertensives between 15 March 2020, and 15 February 2021.</p><p><strong>Main outcome measures: </strong>Severity, clinical course, mortality, and time to PCR negativity between patients using ACEI/ARBs and other antihypertensives.</p><p><strong>Sample size: </strong>435 RESULTS: ACEI/ARBs were used by 203 patients (46.6%) (median age: 71 [41-94] years), while 232 patients (53.4%) were using other antihypertensives (median age: 69 [22-93] years, <i>P</i>=.645 vs age of ACEI/ARB users). There were no statistically significant differences between the ACEI/ARBs users and non-users in the number of patients admitted to intensive care (65 cases [32%] vs. 74 cases [31.9%], <i>P</i>=.978), the median duration of stay in hospital (8 [1-54] days vs.7 [1-55] days, <i>P</i>=.806) the median duration of ICU stay (8 [1-40] days vs. 6 [1-25] days), and the mortality rate (48 cases [23.6%] vs. 61 [26.3%], <i>P</i>=.525). While the median days before transfer to the ICU was shorter in ACE/ARBI non-users (2 [1-15] days vs. 3 [1-21] days, <i>P</i>=.02), the difference was not important clinically. The median time to PCR negativity was similar in ACEI/ARBs users and non-users (13 [7-34] days for users and 13 [5-45] days for non-users), (<i>P</i>=.083).</p><p><strong>Conclusions: </strong>ACEI/ARB use is probably unrelated to poor prognosis in COVID-19 pneumonia inpatients. ACEI/ARBs did not prolong the time to PCR negativity. We conclude that using ACEI/ARBs probably does not increase the infectivity of SARS-CoV-2.</p><p><strong>Limitations: </strong>Pharmacological therapies were not discussed in detail. The use of corticosteroids may affect the time to PCR negativity. We could not analyze the effect of obesity because of a lack of data.</p><p><strong>Conflict of interest: </strong>None.</p>","PeriodicalId":8016,"journal":{"name":"Annals of Saudi Medicine","volume":"41 5","pages":"268-273"},"PeriodicalIF":1.6,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/ff/2a/0256-4947.2021.268.PMC8497007.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39496119","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of pregnancy outcomes between women of advanced maternal age (≥35 years) versus younger women in a tertiary care center in Saudi Arabia.","authors":"Taghreed Shams,&nbsp;Tala Gazzaz,&nbsp;Khalda Althobiti,&nbsp;Nouf Alghamdi,&nbsp;Waleed Bamarouf,&nbsp;Lujain Almarhoumi,&nbsp;Hashem Alhashemi","doi":"10.5144/0256-4947.2021.274","DOIUrl":"https://doi.org/10.5144/0256-4947.2021.274","url":null,"abstract":"<p><strong>Background: </strong>Pregnancy in women aged 35 years or above is generally considered an advanced maternal age (AMA). AMA is associated with an increased rate of maternal and neonatal complications.</p><p><strong>Objectives: </strong>Assess the effect of AMA on maternal and neonatal outcomes.</p><p><strong>Design: </strong>Analytical cross-sectional study of medical records.</p><p><strong>Settings: </strong>In-patient hospital tertiary care setting in Jeddah.</p><p><strong>Patients and methods: </strong>All women who attended antenatal care and delivered at King Abdulaziz Medical City in Jeddah in the first half of 2018 were included in the study. Outcomes for women 35 years of age or older were compared with younger women. Significant factors in a univariate analysis were entered in a multiple logistic regression model to assess the association between AMA and outcomes.</p><p><strong>Main outcome measures: </strong>Rates of maternal neonatal complications, analysis of factors associated with advanced maternal, gestational diabetes mellitus (GDM), cesarean delivery.</p><p><strong>Sample size: </strong>1586 women.</p><p><strong>Results: </strong>Of the 1586 women, 406 were 35 years of age or older (25.6%), and 1180 were younger than 35 years. The AMA group had a significantly higher proportion of GDM (32.0% versus 13.2%, <i>P</i><.001). The adjusted odds ratio (OR) for GDM was 2.6 (95% CI 2-3.5, <i>P</i><.001.) compared with younger women in the multivariate logistic regression analysis. Older women had a higher rate of cesarean delivery (43.6% versus 30.8%, <i>P</i><.001). The adjusted OR for cesarean vs. vaginal delivery was 1.5 (CI 1.2-1.9, <i>P</i>=.002).</p><p><strong>Conclusion: </strong>Pregnancy in women 35 years or older was associated with an increased risk of GDM and cesarean delivery.</p><p><strong>Limitations: </strong>Cross-sectional design, small sample size, single hospital.</p><p><strong>Conflict of interest: </strong>None.</p>","PeriodicalId":8016,"journal":{"name":"Annals of Saudi Medicine","volume":"41 5","pages":"274-279"},"PeriodicalIF":1.6,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/cd/9c/0256-4947.2021.274.PMC8497009.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39496121","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}