Annals of Saudi Medicine最新文献

{"title":"Acute gastroenteritis-related acute kidney injury in a tertiary care center.","authors":"Mohammed Hisham Bogari,&nbsp;Adeeb Munshi,&nbsp;Saleh Almuntashiri,&nbsp;Asim Bogari,&nbsp;Abdullah Shaker Abdullah,&nbsp;Mohammed Albadri,&nbsp;Ameer Hashim,&nbsp;Mohammed Saeed AlZahrani","doi":"10.5144/0256-4947.2023.82","DOIUrl":"https://doi.org/10.5144/0256-4947.2023.82","url":null,"abstract":"<p><strong>Background: </strong>Acute gastroenteritis (AGE) can cause acute kidney injury (AKI) via hypoperfusion mechanisms. Early detection of AKI caused by AGE can significantly decrease mortality rates. In Saudi Arabia, studies investigating the association between AGE and AKI are limited; thus, we aimed to fill this knowledge gap.</p><p><strong>Objectives: </strong>Analyze all cases of AGE reported in tertiary-care hospitals to assess the prevalence of AKI among AGE patients.</p><p><strong>Design: </strong>Retrospective cohort SETTINGS: Single tertiary-care center PATIENTS AND METHODS: The study included patients treated for AGE between October 2017 and October 2022. Stool culture was used to diagnose AGE. Inclusion criteria were infective diarrhea and/ or vomiting, and availability of data (demographics, comorbidities, malignancies, length of hospital stay, vital signs at the time of diagnosis, dehydration, causative agents of diarrhea, hemodialysis status, and laboratory data.</p><p><strong>Main outcome measures: </strong>Prevalence of AKI among AGE patients and factors associated with development of AKI.</p><p><strong>Sample size: </strong>300 patients diagnosed with AGE.</p><p><strong>Results: </strong>Of the 300 patients with AGE, 41 (13.6%) had AKI, those older than 60 years were more likely to develop AKI. The most frequent cause of AGE was <i>Salmonella spp</i>. (n=163, 53.3%), whereas AKI was most common in <i>Clostridium difficile</i> AGE patients (n=21, 51.2%). Furthermore, the most common comorbidity in the present study was malignancy, especially leukemia and lymphoma the risk of AKI was independently associated with mild dehydration, higher serum urea concentrations and low GFR values.</p><p><strong>Conclusions: </strong>Patients hospitalized for diarrheal disease are at an increased risk of developing AKI due to dehydration and comorbid conditions. It is crucial to keep kidney function in mind for AGE patients as this is associated with a high mortality rate and poor prognosis.</p><p><strong>Limitations: </strong>The main limitation of this study was its retrospective design. Another limitation is that it is limited to a single center.</p><p><strong>Conflicts of interest: </strong>None.</p>","PeriodicalId":8016,"journal":{"name":"Annals of Saudi Medicine","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/e0/f9/0256-4947.2023.82.PMC10082947.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9283627","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":"To Sir, With Love.","authors":"Nasser Alsanea","doi":"10.5144/0256-4947.2023.115","DOIUrl":"https://doi.org/10.5144/0256-4947.2023.115","url":null,"abstract":"<p><p>In this biography, the life of William Hugh Isbister is traced through three continents, where he planted the seeds of academic surgery into a generation of leaders in colorectal surgery. This ultimately improved the care for thousands of patients. His last station in Saudi Arabia made a huge impact on the country. I hope this article inspires others to write about their mentors who were important in their development as surgeons and physicians. Short biographies of these important figures will serve as a valuable historical record for generations to come.</p>","PeriodicalId":8016,"journal":{"name":"Annals of Saudi Medicine","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/92/9a/0256-4947.2023.115.PMC10082942.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9299377","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":"Gut microbiota in Chinese and Japanese patients with cardiovascular diseases: a systematic review and meta-analysis.","authors":"Linjie Liao,&nbsp;Junli Huang,&nbsp;Jinghui Zheng,&nbsp;Xiaocong Ma,&nbsp;Longjian Huang,&nbsp;Wenhua Xu","doi":"10.5144/0256-4947.2023.105","DOIUrl":"https://doi.org/10.5144/0256-4947.2023.105","url":null,"abstract":"<p><strong>Background: </strong>Cardiovascular disease (CVD) is a major threat to public health.</p><p><strong>Objective: </strong>Compare the gut microbial composition between Chinese and Japanese patients with cardiovascular diseases and healthy subjects.</p><p><strong>Study selection: </strong>Observational studies with Chinese and Japanese populations. Reviews, duplicate, book chapters, and other irrelevant studies were excluded.</p><p><strong>Data extraction: </strong>Independent searching by two investigators (LLJ, HJL).</p><p><strong>Data synthesis: </strong>Data from eleven studies (with 960 subjects) were included for the meta-analysis. The meta-analysis showed that the abundance of Firmicutes in patients with cardiovascular disease was [ES=0.42, 95%CI, (0.34, 0.50), <i>P</i><.01], while the abundance of Firmicutes in control subjects was [ES=0.36, 95%CI, (0.23, 0.49), <i>P</i><.01] (ES: effect size). When compared to control subjects, the differential expression of Firmicutes abundance in patients with CVDs was [MD = 15.21, 95%CI (8.95, 21.48), <i>P</i><.01] (MD: mean difference). The ratio of Firmicutes abundance in patients with CVDs to the control subjects was [RR=1.28, 95%CI (0.98, 1.67), <i>P</i>=.07]. The ratio of Firmicutes in coronary heart disease (CHD) patients and controls was [RR=1.42, 95%CI (1.05, 1.94), <i>P</i>=.02]. Firmicutes/Bacteroidetes ratio is [OR=1.64 95%CI (1.11, 2.42), <i>P</i>=.01].</p><p><strong>Conclusion: </strong>Our data show that patients with cardiovascular disease had higher levels of gut Firmicutes when compared to healthy controls. In addition, gut microbial dysbiosis was present in patients with cardiovascular diseases.</p><p><strong>Limitations: </strong>Due to limited quality and quantity of selected studies, conclusions from the current study need to be validated by future studies.</p><p><strong>Conflict of interest: </strong>None.</p>","PeriodicalId":8016,"journal":{"name":"Annals of Saudi Medicine","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/39/0a/0256-4947.2023.105.PMC10082944.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9283623","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":"Surgical outcomes and prognostic factors associated with emergency left colonic surgery.","authors":"Dauda Bawa,&nbsp;Yasser Mohammad Khalifa,&nbsp;Saleem Khan,&nbsp;Waddah Norah,&nbsp;Nibras Noman","doi":"10.5144/0256-4947.2023.97","DOIUrl":"https://doi.org/10.5144/0256-4947.2023.97","url":null,"abstract":"<p><strong>Background: </strong>Mortality from emergency left-sided colorectal surgery can be substantial due to acuteness of the presentation and the urgent need to operate in the setting of a limited preparation in a morbid patient.</p><p><strong>Objectives: </strong>Determine the 30-day postoperative outcomes and identify risk factors for complications and mortality following emergency colorectal operations.</p><p><strong>Design: </strong>Retrospective SETTINGS: Three tertiary hospitals in three countries.</p><p><strong>Patients and methods: </strong>Factors that were studied included age, sex, ASA score, type and extent of the operation, and presence/absence of malignancy. Unadjusted 30-day patient outcomes examined were complications and mortality. Differences in proportions were assessed using the Pearson chi-square test while logistic regression analyses were carried out to evaluate the correlation between risk factors and outcomes.</p><p><strong>Main outcome measures: </strong>30-day postoperative morbidity and mortality SAMPLE SIZE: 104 patients.</p><p><strong>Results: </strong>Among 104 patients, 70 (67.3%) were men, and 34 (32.7%) were women. The mean (SD) age was 57.2 (17.1) years. The most common indication for emergency colonic surgery was malignant obstruction in 33 (31.7%) patients. The postoperative complication rate was 24% (25/104), and the mortality rate was 12.5% (13/104) within 30 days of the operation. The ASA status (<i>P</i>=.02), presence of malignancy (<i>P</i>=.02), and the presence of complications (<i>P</i>=.004) were significantly related to mortality in the multivariable logistic regression analysis.</p><p><strong>Conclusions: </strong>The 30-day mortality of emergency colorectal operations is greatly influenced by the presence of malignancy in the colon and physiological status at the time of the procedure.</p><p><strong>Limitations: </strong>The retrospective design and small sample size.</p><p><strong>Conflict of interest: </strong>None.</p>","PeriodicalId":8016,"journal":{"name":"Annals of Saudi Medicine","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/de/2b/0256-4947.2023.97.PMC10082940.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9283625","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":"A comparison of the perineal and penoscrotal approaches in artificial urinary sphincter implantation for the control of male stress urinary incontinence.","authors":"Waleed Altaweel,&nbsp;Razan Almesned,&nbsp;Raouf Seyam","doi":"10.5144/0256-4947.2023.57","DOIUrl":"https://doi.org/10.5144/0256-4947.2023.57","url":null,"abstract":"<p><strong>Background: </strong>The two most common surgical approaches to treat stress urinary incontinence in men are the traditional perineal and the new penoscrotal approach for artificial urinary sphincter (AUS) implantation. Each method carries its own advantages and disadvantages. The few reports that compare the approaches have disparate outcomes.</p><p><strong>Objective: </strong>Compare the outcome of first time AUS implantation by the perineal versus the penoscrotal approach.</p><p><strong>Design: </strong>Retrospective study.</p><p><strong>Setting: </strong>Tertiary referral center.</p><p><strong>Patients and methods: </strong>We included all male patients who underwent primary perineal or penoscrotal AUS placement between June 2004 and October 2018 at our tertiary care hospital. Patients were followed at least one year postoperatively.</p><p><strong>Main outcome measures: </strong>Rates of dry, infection, erosion, malfunction, atrophy, revision.</p><p><strong>Sample size: </strong>44 males who underwent 68 procedures.</p><p><strong>Results: </strong>Twenty-five (56.8%) patients underwent a perineal and 19 (43.2%) underwent a penoscrotal approach. The patients had 68 procedures: 36 (52.9%) perineal and 32 (47.1%) penoscrotal approaches. The median (25th-75th percentiles) age at the time of surgery was 61.0 (51.0-68.0) years (n=68 procedures). The median (25th-75th percentiles) operative time was significantly shorter for the penoscrotal approach, 87 (69-140), vs. 93 (72-210) minutes for the perineal approach (<i>P</i>=.016). The 44 patients were followed up for a mean (SD) of 52.5 (20.3) months for the 68 procedures. Postoperative complications occurred in 16 (36.36%) patients; 11 (44%) perineal approach patients and 5 (26.3%) penoscrotal. There were no significant differences in complications of infection, erosion, malfunction, or urethral atrophy between the two groups. Only removal/revision was significantly more common with the perineal approach (10 patients perineal and two patients penoscrotal, <i>P</i>=.042). At the last follow-up, dryness was comparable among groups.</p><p><strong>Conclusion: </strong>The outcomes of AUS placement are comparable between perineal and penoscrotal approaches in terms of complications and one year dryness. The penoscrotal approach however has shorter operative time and less need for revision and removal.</p><p><strong>Limitations: </strong>Small sample size, single-center.</p><p><strong>Conflict of interest: </strong>None.</p>","PeriodicalId":8016,"journal":{"name":"Annals of Saudi Medicine","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/b8/ba/0256-4947.2023.57.PMC9899335.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10792488","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":"Efficacy and safety of empagliflozin: a \"real-world\" experience from Saudi Arabia.","authors":"Muhammad Imran Butt,&nbsp;Hadeel Aljamei,&nbsp;Muhammad Riazuddin,&nbsp;Lamia AlHaqbani,&nbsp;Roaa Albalwi,&nbsp;Fayha Farraj Mansour Abothenain,&nbsp;Nahlah Abdullah Mohammed Alagla,&nbsp;Najeeb Waheed","doi":"10.5144/0256-4947.2023.50","DOIUrl":"https://doi.org/10.5144/0256-4947.2023.50","url":null,"abstract":"<p><strong>Background: </strong>Sodium-glucose cotransporter 2 (SGLT2) inhibitors are new agents for treating type 2 diabetes. In addition to the glycemic benefits, these agents provide cardiorenal protection in patients with diabetes and without diabetes. There is consistent evidence that these agents increase the risk of genitourinary infections and dehydration, but randomized controlled trials have not included patients from the Middle East.</p><p><strong>Objectives: </strong>Determine the efficacy and safety of empagliflozin, specifically whether the genitourinary infection risk differs in our population and whether there is an increased risk of dehydration, ketoacidosis, hypoglycemia, and hospitalization with fasting.</p><p><strong>Design: </strong>Retrospective review of medical records.</p><p><strong>Settings: </strong>Department of medicine at tertiary care center.</p><p><strong>Patients and methods: </strong>We reviewed the electronic records of patients with type 2 diabetes who took empagliflozin from 1 December 2018 to 30 November 2019. We collected safety and efficacy data for 12 months from the initiation of treatment.</p><p><strong>Main outcomes measures: </strong>Glycemic and weight loss efficacy, risk of hospitalization due to hypoglycemia, dehydration, and genitourinary infections.</p><p><strong>Sample size: </strong>637 patients.</p><p><strong>Results: </strong>We observed an improvement in glycated hemoglobin, a 4.2% weight loss, improved left ventricular function, stable serum creatinine, and reduced albuminuria. Our patients did not have an increased risk of genitourinary infections, hypoglycemia, dehydration, ketoacidosis, or hospitalizations. Fasting did not increase the incidence of adverse events.</p><p><strong>Conclusions: </strong>Empagliflozin is safe and effective in our local population. We hypothesize that glycosuria induced by empagliflozin is not the sole contributor to the increased risk of genitourinary infections. Local hygiene and circumcision might reduce this risk. Empagliflozin can be used safely during fasting.</p><p><strong>Limitations: </strong>Retrospective design.</p><p><strong>Conflict of interest: </strong>None.</p>","PeriodicalId":8016,"journal":{"name":"Annals of Saudi Medicine","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/e1/a7/0256-4947.2023.50.PMC9899336.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10737227","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 relationship between degree of coronary artery stenosis detected by coronary computed tomography angiography and ACEF risk score in patients with chronic coronary syndrome.","authors":"Mehmet Kis,&nbsp;Ferhat Siyamend Yurdam","doi":"10.5144/0256-4947.2023.35","DOIUrl":"https://doi.org/10.5144/0256-4947.2023.35","url":null,"abstract":"<p><strong>Background: </strong>The ACEF risk score (age, creatinine, and ejection fraction) has been associated with satisfactory predictive values not only for short-term and long-term mortality but also for major adverse cardiovascular events.</p><p><strong>Objectives: </strong>Investigate the relationship between ACEF risk score and degree of coronary artery stenosis.</p><p><strong>Design: </strong>Retrospective, observational study.</p><p><strong>Setting: </strong>Tertiary percutaneous coronary intervention center.</p><p><strong>Patients and methods: </strong>In patients with coronary coronary artery stenosis <70% were compared with patients with stenosis ≥70%. All were diagnosed with chronic coronary syndrome (CCS) and had undergone coronary computed tomography angiography (CTA). Receiver operating characteristic analysis was performed for the cut-off value of the ACEF risk score. Univariable and multivariable regression analyses were performed for significant parameters related to degree of coronary artery stenosis in coronary CTA.</p><p><strong>Main outcome measures: </strong>Relationship between ACEF risk score and degree of coronary artery stenosis in coronary CTA.</p><p><strong>Sample size: </strong>148 patients.</p><p><strong>Results: </strong>In the multivariable regression analysis; left ventricular ejection fraction (OR: 0.94; 95%CI: 0.89-0.99, <i>P</i>=.015) and ACEF risk score (OR: 5.63; 95% CI: 1.62-19.57, <i>P</i>=.007) were independent predictors for degree of coronary artery stenosis. The ACEF risk score was statistically significantly higher in with patients with stenosis ≥70% (1.43 [0.59]) than in patients with stenosis <70% (0.98 [0.35]), <i>P</i><.001). An ACEF risk score value >1.04 was a predictor of the presence of severe coronary artery stenosis detected by coronary CTA in patients with CCS, with 66% sensitivity and 69% specificity.</p><p><strong>Conclusions: </strong>A high ACEF risk score (age, creatinine, ejection fraction) in patients with CCS is associated with the presence of severe coronary artery stenosis detected by coronary CTA, and was useful as an assessment tool for coronary angiography in patients with CCS.</p><p><strong>Limitations: </strong>Since we do not have long-term follow-up results, we do not know the prognostic value of the ACEF risk score in the long-term follow-up of patients with CCS.</p><p><strong>Conflict of interest: </strong>None.</p>","PeriodicalId":8016,"journal":{"name":"Annals of Saudi Medicine","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/97/fe/0256-4947.2023.35.PMC9899341.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10792487","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 combined impact of hyponatremia and hematocrit on the risk for 90-day readmission and death in patients with heart failure: dilutional hyponatremia versus depletional hyponatremia.","authors":"Jiahuan Rao,&nbsp;Yusheng Ma,&nbsp;Jieni Long,&nbsp;Yan Tu,&nbsp;Zhigang Guo","doi":"10.5144/0256-4947.2023.17","DOIUrl":"https://doi.org/10.5144/0256-4947.2023.17","url":null,"abstract":"<p><strong>Background: </strong>Hyponatremia is common in hospitalized patients with heart failure (HF) and predicts a poor prognosis after discharge. In general, hyponatremia can be divided into two types: dilutional or depletional.</p><p><strong>Objective: </strong>Assess the impact of hyponatremia type on short-term outcomes.</p><p><strong>Design: </strong>Retrospective cohort SETTINGS: Single center in China PATIENTS AND METHODS: We sorted patients by hyponatremia into two types: dilutional hyponatremia (DiH, with hematocrit <35%) and depletional hyponatremia (DeH, with hematocrit ≥35%). The Kaplan-Meier method and Cox regression analysis were used to identify the impact of hyponatremia types on the risk for 90-day readmission and death.</p><p><strong>Main outcome measures: </strong>90-day readmission and death combined.</p><p><strong>Sample size: </strong>1770 patients.</p><p><strong>Results: </strong>Hyponatremia was present in 324/1770 patients with 182 cases classified as DiH versus 142 as DeH. Kaplan-Meier analyses showed a higher incidence of poor short-term outcomes in hyponatremia compared with normonatremia (log-rank <i>P</i><.001), and the risk was higher in DiH than DeH although the difference was not statistically significant (log-rank <i>P</i>=.656). Multivariate Cox regression analyses showed that only DiH was independently associated with short-term outcomes (HR=1.34, 95%CI: 1.02-1.77, <i>P</i>=.038), but not DeH (HR=1.32, 95%CI: 0.97-1.80, <i>P</i>=.081). Analysis of the secondary endpoints showed that DiH increased the risk of readmission but not death (HR=1.36, <i>P</i>=.035 for readmission; HR=1.13, <i>P</i>=.831 for all-cause death).</p><p><strong>Conclusions: </strong>Low hematocrit, rather than high hematocrit, with hyponatremia was associated with a risk of 90-day readmission in patients with HF.</p><p><strong>Limitations: </strong>Single center, nonrandomized.</p><p><strong>Conflict of interest: </strong>None.</p>","PeriodicalId":8016,"journal":{"name":"Annals of Saudi Medicine","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/a9/f5/0256-4947.2023.17.PMC9899337.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10737228","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":"Factors associated with development of an acute ischemic event during hospitalization for COVID-19 in cancer and non-cancer patients.","authors":"Arif Hakan Onder,&nbsp;Aysegul Seremet Keskin,&nbsp;Kubra Demir Onder,&nbsp;Filiz Kizilates,&nbsp;Cihan Heybeli","doi":"10.5144/0256-4947.2023.1","DOIUrl":"https://doi.org/10.5144/0256-4947.2023.1","url":null,"abstract":"<p><strong>Background: </strong>COVID-19 and solid cancer are both associated with an increased risk of thromboembolism.</p><p><strong>Objectives: </strong>Assess whether solid cancer is a risk factor for acute ischemic event development among patients with COVID-19.</p><p><strong>Design: </strong>Retrospective cohort SETTING: A tertiary training and research hospital PATIENTS AND METHODS: Patients who were hospitalized for COVID-19 for ≥3 days between 15 March 2020 and 30 March 2021 at Antalya Training and Research Hospital, Antalya, Turkiye. were included in the study. Independent predictors of the development of acute ischemic events during hospitalization were determined using multivariable logistic regression analysis.</p><p><strong>Main outcome measures: </strong>Risk factors for acute ischemic event development.</p><p><strong>Sample size: </strong>538 patients.</p><p><strong>Results: </strong>Patients diagnosed with solid cancer comprised 11.3% of the cohort (n=61). Forty-one (7.6%) developed an acute ischemic event at a median of 3 (range, 1-15) days after hospitalization. The presence of a solid cancer (OR 3.80, 95% CI 1.20-12.03, <i>P</i>=.023) along with length of hospital stay (OR 1.05 per day, 95% CI 1.01-1.09, <i>P</i>=.025) were independent predictors of acute ischemic event development during the course of COVID-19. Mortality was reported in 200 (37%) patients at a median of 5 (range, 3-10) days after hospitalization. The presence of solid tumor increased mortality 5.83 times (95% CI 3.19-10.63, <i>P</i><.001) while this ratio was 4.59 (95% CI 2.29-9.23, <i>P</i><.001) for patients who experienced an acute ischemic event.</p><p><strong>Conclusion: </strong>Patients with active cancer carry a significant risk for acute ischemic event development during the course of COVID-19 and such patients may require particular attention in terms of anticoagulation therapy.</p><p><strong>Limitations: </strong>Retrospective design and small sample size.</p><p><strong>Conflict of interest: </strong>None.</p>","PeriodicalId":8016,"journal":{"name":"Annals of Saudi Medicine","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/3e/29/0256-4947.2023.1.PMC9899339.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10792946","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":"Efficacy of bedside optic nerve sheath diameter measurement in differentiating provoked seizure from unprovoked seizure in the emergency department.","authors":"Fevzi Yılmaz,&nbsp;Bedriye Muge Sonmez,&nbsp;Cemil Kavalci,&nbsp;Engin Deniz Arslan,&nbsp;Gulsum Caliskan,&nbsp;Inan Beydilli","doi":"10.5144/0256-4947.2023.42","DOIUrl":"https://doi.org/10.5144/0256-4947.2023.42","url":null,"abstract":"<p><strong>Background: </strong>Emergency departments (EDs) are typically the first medical contact for seizure patients, and early diagnosis and treatment is primarily the responsibility of emergency physicians.</p><p><strong>Objectives: </strong>Demonstrate the efficacy of bedside ocular ultrasonography for optic nerve sheath diameter (ONSD) measurement in differentiating provoked seizure from unprovoked seizure in the ED.</p><p><strong>Design: </strong>Prospective observational study SETTINGS: Tertiary care hospital PATIENTS AND METHODS: Patients presenting to the ED with seizure were divided into two groups according to medical history, physical examination, laboratory results, cranial computed tomography findings and electroencephalography results. Patients with seizures that did not have a specific cause (unprovoked) were compared with patients who had seizures caused by underlying pathology (provoked). The measurement of the ONSD was taken at the bedside within 30 minutes of arrival. The study compared the ONSD values, age, sex, type of seizure, and Glasgow Coma Score between the two groups.</p><p><strong>Main outcome measure: </strong>Efficacy of ONSD to distinguish between provoked and unprovoked seizures.</p><p><strong>Sample size: </strong>210 patients RESULTS: One hundred and fourteen (54.3%) patients were in the provoked seizure group and 96 (45.7%) were in the unprovoked seizure group. The ONSD measurements were significantly higher in the provoked seizure group compared with the unprovoked seizure group (median 6.1 mm vs. 5.2 mm, <i>P</i><.001). The cut-off value of ONSD higher than 5.61 was significantly associated with the prediction of the provoked seizure (<i>P</i><.001). The area under the curve value was 0.882 (95% CI: 0.830-0.922) with a sensitivity of 86.5 and specificity of 78.9%.</p><p><strong>Conclusions: </strong>Bedside ONSD measurement by means of ocular ultrasound is an effective method for differentiating provoked seizure from unprovoked seizure.</p><p><strong>Limitations: </strong>Statistical significance of age on ONSD and exclusion of pediatric patients.</p><p><strong>Conflict of interest: </strong>None.</p>","PeriodicalId":8016,"journal":{"name":"Annals of Saudi Medicine","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/ee/55/0256-4947.2023.42.PMC9899342.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9619236","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}