The etiopathogenesis of uterine leiomyomas: A review

To summarize the available literature data on the etiopathogenesis of uterine fibroids as well as the risk factors for the development of this diseas

Effect of Depth of Total Intravenous General Anesthesia on Intraoperative Electrically Evoked Compound Action Potentials in Cochlear Implantation Surgery.

PURPOSE: This study aims to compare the effect of the depth of total intravenous anesthesia (TIVA) on intraoperative electrically evoked compound action potential (e-ECAP) thresholds in cochlear implant operations. METHODS: Prospectively, a total of 39 patients aged between 1 and 48 years who were scheduled to undergo cochlear implantation surgeries were enrolled in this study. Every patient received both light and deep TIVA during the cochlear implant surgery. The e-ECAP thresholds were obtained during the light and deep TIVA. RESULTS: After comparing the e-ECAP means for each electrode (lead) between the light and deep anesthesia, no significant differences were detected between the light and deep anesthesia. CONCLUSION: The depth of TIVA may have no significant influence on the e-ECAP thresholds as there was no statistical difference between the light and deep anesthesia

The relationship between statins and diabetic retinopathy: A review of literature

BackgroundTreatment with statins is a robust strategy in reducing cardiovascular complications among patients with diabetes mellitus and chronic kidney disease. There is an increasing awareness regarding the association of statins with diabetic retinopathy.AimsThe current review aimed to assess the relationship of statins therapy to diabetic retinopathy.Methods The literature in PubMed and Google Scholar was searched for relevant articles from the first available article up to present using the terms statins, simvastatin, atorvastatin, pravastatin, and diabetic retinopathy. Among the 169 articles retrieved, 26 full-texts were assessed for eligibility and only sixteen studies (four from the USA, another four from Europe, six from Asia, and one from Australia and Brazil each) met the inclusion criteria for the systematic review. The author name, year of publication, country, type of study, number of patients, and the duration of the study were reported.ResultsThe studies reviewed showed that statins reduce the development of diabetic retinopathy, retard the progression of hard exudates and micro-aneurisms, reduce retinopathy and macular oedema.ConclusionStatins prevent and reduce the progression of diabetic retinopathy and macular oedema

Comparison of Outcomes in Level I vs Level II Trauma Centers in Patients Undergoing Craniotomy or Craniectomy for Severe Traumatic Brain Injury.

BACKGROUND: Traumatic brain injury (TBI) carries a devastatingly high rate of morbidity and mortality. OBJECTIVE: To assess whether patients undergoing craniotomy/craniectomy for severe TBI fare better at level I than level II trauma centers in a mature trauma system. METHODS: The data were extracted from the Pennsylvania Trauma Outcome Study database. Inclusion criteria were patients \u3e 18 yr with severe TBI (Glasgow Coma Scale [GCS] score less than 9) undergoing craniotomy or craniectomy in the state of Pennsylvania from January 1, 2002 through September 30, 2017. RESULTS: Of 3980 patients, 2568 (64.5%) were treated at level I trauma centers and 1412 (35.5%) at level II centers. Baseline characteristics were similar between the 2 groups except for significantly worse GCS scores at admission in level I centers (P = .002). The rate of in-hospital mortality was 37.6% in level I centers vs 40.4% in level II centers (P = .08). Mean Functional Independence Measure (FIM) scores at discharge were significantly higher in level I (10.9 ± 5.5) than level II centers (9.8 ± 5.3; P \u3c .005). In multivariate analysis, treatment at level II trauma centers was significantly associated with in-hospital mortality (odds ratio, 1.2; 95% confidence interval, 1.03-1.37; P = .01) and worse FIM scores (odds ratio, 1.4; 95% confidence interval, 1.1-1.7; P = .001). Mean hospital and ICU length of stay were significantly longer in level I centers (P \u3c .005). CONCLUSION: This study showed superior functional outcomes and lower mortality rates in patients undergoing a neurosurgical procedure for severe TBI in level I trauma centers

The relationship between periodontitis and diabetic retinopathy: A cross-sectional longitudinal study

BackgroundPeriodontal disease is regarded as the sixth complication of diabetes mellitus. The association of periodontitis with diabetic retinopathy is controversial.AimsThe study aimed to assess the association of periodontitis with diabetic retinopathy.Methods This is a cross-sectional descriptive study conducted at a diabetes centre in Omdurman, Sudan during the period from July to September 2018. One hundred and fifty-nine patients with type 2 diabetes were interviewed using a structured checklist. The demographic data and diabetes complications including retinopathy were recorded. An experienced dentist assessed the participants for periodontitis. The Statistical Package for Social Sciences (SPSS, version 20, New York) was used for data analysis. A P-value of > 0.05 was considered significant.Results Out of 159 patients with type 2 diabetes mellitus (65.4 per cent females), their age mean±SD was 58.13±9.96, periodontal diseases were found in 22.0 per cent of patients, and retinopathy was present in 34.6 per cent, while the number of lost teeth was 3.86±3.05. Between patients, periodontal disease (+) vs. (-), the incidence rate of the followings did not differ retinopathy, neuropathy, nephropathy, and coronary history. However, those with periodontal disease, compared with those without, had significantly more lost teeth P-value < 0.05.ConclusionThe number of lost teeth was higher among patients with diabetic retinopathy. However, a cause and effect cannot be withdrawn. Further larger multi-centre studies assessing the association of retinopathy with the severity of periodontal disease and controlling for other causes of teeth loss are needed

The relationship between diet soda soft drinks, artificial sweeteners, and diabetic retinopathy

BackgroundThe relationship between diabetic retinopathy and diet-drink (soft soda), non-nutritive sweeteners have not been fully determined. We here attempted to determine it.AimsThe study aimed to assess the association between soda soft drinks, non-nutritive sweeteners, and diabetic retinopathy.Methods A cross-sectional descriptive study was conducted at a diabetes center in Tabuk city, Saudi Arabia from September 2019 to April 2020: 174 patients with type 2 diabetes mellitus (DM) were interviewed using a structured questionnaire: demographic data, the DM duration, the lifestyles (exercise, smoking, and diet), and the medications. The weekly amount of diet soda and daily consumption of non-nutritive sweeteners were assessed. These were analysed with association with retinopathy.Results The glycated haemoglobin per cent was 8.50±1.60, the diet soda and artificial sweeteners consumptions were 1.18±1.57 cans/week and 0.89±1.26 sachets/day, respectively. No association was found between artificial sweeteners, diet soda, and diabetic retinopathy (Wald, 1.251, and 0.213, P-values, 0.263, and 0.644, 95 per cent CI, 0.583–7.204, and 0.190–2.793 respectively). Retinopathy incidence was associated with the DM duration (Wald, 8.095, P-value, 0.004, and 95 per cent CI, 0.766–0.952).ConclusionDiet soda and non-nutritive sweeteners were not associated with diabetic retinopathy, irrespective of gender or body mass index. Diabetic retinopathy was associated with the duration of DM after its first diagnosis

Retail Chicken Carcasses as a Reservoir of Multidrug-Resistant .

is a major cause of foodborne disease outbreaks worldwide, mainly through poultry. Recently, there has been an increase in multidrug-resistant (MDR) infections globally. The increased drug resistance results in increased costs and poorer health outcomes due to unavailability or delayed treatment. This study aims to determine the prevalence of in retail raw chicken meat and identify their antimicrobial resistance profiles. A total of 270 retail raw chicken carcasses (local and imported) were collected from three hypermarket chains in Qatar between November 2017 and April 2018. Thirty carcasses were contaminated with (11.11%). The prevalence of in locally produced chicken was higher than in imported chicken (OR = 2.56, 95% CI: 1.18-5.53,  = 0.016). No significant differences were found between the prevalence and storage temperature or hypermarket chain. The highest resistance rates in the isolates were reported to tetracycline (73.7%) followed by nitrofurantoin (53.3%), ampicillin (50%), amoxicillin-clavulanic acid, ceftriaxone (26.7%), and ciprofloxacin (23.3%). Eight isolates were potential extended-spectrum β-lactamase-producers, all in imported frozen chicken ( < 0.0001). Additionally, 43.3% of the isolates were MDR and associated with frozen chicken (OR = 16.88, 95% CI: 2.55-111.47,  = 0.002). The findings indicate that while the prevalence of in retail chicken in Qatar is moderate, a large proportion of them are MDR.This research was funded by, Biomedical Research Centre, Qatar University, grant number “BRC-2018-ID-01 to Nahla O. Eltai.

ANO4 Expression Is a Potential Prognostic Biomarker in Non-Metastasized Clear Cell Renal Cell Carcinoma

Background: Over the past decade, transcriptome profiling has elucidated many pivotal pathways involved in oncogenesis. However, a detailed comprehensive map of tumorigenesis remains an enigma to solve. Propelled research has been devoted to investigating the molecular drivers of clear cell renal cell carcinoma (ccRCC). To add another piece to the puzzle, we evaluated the role of anoctamin 4 (ANO4) expression as a potential prognostic biomarker in non-metastasized ccRCC. Methods: A total of 422 ccRCC patients with the corresponding ANO4 expression and clinicopathological data were obtained from The Cancer Genome Atlas Program (TCGA). Differential expression across several clinicopathological variables was performed. The Kaplan–Meier method was used to assess the impact of ANO4 expression on the overall survival (OS), progression-free interval (PFI), disease-free interval (DFI), and disease-specific survival (DSS). Univariate and multivariate Cox logistic regression analyses were conducted to identify independent factors modulating the aforementioned outcomes. Gene set enrichment analysis (GSEA) was used to discern a set of molecular mechanisms involved in the prognostic signature. Tumor immune microenvironment was estimated using xCell. Results: ANO4 expression was upregulated in tumor samples compared to normal kidney tissue. Albeit the latter finding, low ANO4 expression is associated with advanced clinicopathological variables such as tumor grade, stage, and pT. In addition, low ANO4 expression is linked to shorter OS, PFI, and DSS. Multivariate Cox logistic regression analysis identified ANO4 expression as an independent prognostic variable in OS (HR: 1.686, 95% CI: 1.120–2.540, p = 0.012), PFI (HR: 1.727, 95% CI: 1.103–2.704, p = 0.017), and DSS (HR: 2.688, 95% CI: 1.465–4.934, p = 0.001). GSEA identified the following pathways to be enriched within the low ANO4 expression group: epithelial–mesenchymal transition, G2-M checkpoint, E2F targets, estrogen response, apical junction, glycolysis, hypoxia, coagulation, KRAS, complement, p53, myogenesis, and TNF-α signaling via NF-κB pathways. ANO4 expression correlates significantly with monocyte (ρ = −0.1429, p = 0.0033) and mast cell (ρ = 0.1598, p = 0.001) infiltration. Conclusions: In the presented work, low ANO4 expression is portrayed as a potential poor prognostic factor in non-metastasized ccRCC. Further experimental studies should be directed to shed new light on the exact molecular mechanisms involved.The article processing charges were funded jointly by Qatar National Library and Qatar University

Cyclin dependent kinase inhibitor 3 (CDKN3) upregulation is associated with unfavorable prognosis in clear cell renal cell carcinoma and shapes tumor immune microenvironment: A bioinformatics analysis

Cell cycle regulatory proteins plays a pivotal role in the development and progression of many human malignancies. Identification of their biological functions as well as their prognostic utility presents an active field of research. As a continuation of the ongoing efforts to elucidate the molecular characteristics of clear cell renal cell carcinoma (ccRCC); we present a comprehensive bioinformatics study targeting the prognostic and mechanistic role of cyclin-dependent kinase inhibitor 3 (CDKN3) in ccRCC. The ccRCC cohort from the Cancer Genome Atlas Program was accessed through the UCSC Xena browser to obtain CDKN3 mRNA expression data and their corresponding clinicopathological variables. The independent prognostic signature of CDKN3 was evaluated using univariate and multivariate Cox logistic regression analysis. Gene set enrichment analysis and co-expression gene functional annotations were used to discern CDKN3-related altered molecular pathways. The tumor immune microenvironment was evaluated using TIMER 2.0 and gene expression profiling interactive analysis. CDKN3 upregulation is associated with shortened overall survival (hazard ratio [HR] = 2.325, 95% confident interval [CI]: 1.703–3.173, P < .0001) in the Cancer Genome Atlas Program ccRCC cohort. Univariate (HR: 0.426, 95% CI: 0.316–0.576, P < .001) and multivariate (HR: 0.560, 95% CI: 0.409–0.766, P < .001) Cox logistic regression analyses indicate that CDKN3 is an independent prognostic variable of the overall survival. High CDKN3 expression is associated with enrichment within the following pathways including allograph rejection, epithelial–mesenchymal transition, mitotic spindle, inflammatory response, IL-6/JAK/STAT3 signaling, spermatogenesis, TNF-α signaling via NF-kB pathway, complement activation, KRAS signaling, and INF-γ signaling. CDKN3 is also associated with significant infiltration of a wide spectrum of immune cells and correlates remarkably with immune-related genes. CDKN3 is a poor prognostic biomarker in ccRCC that alters many molecular pathways and impacts the tumor immune microenvironment.Scopu

The Glasgow Outcome Scale -- 40 years of application and refinement

The Glasgow Outcome Scale (GOS) was first published in 1975 by Bryan Jennett and Michael Bond. With over 4,000 citations to the original paper, it is the most highly cited outcome measure in studies of brain injury and the second most-cited paper in clinical neurosurgery. The original GOS and the subsequently developed extended GOS (GOSE) are recommended by several national bodies as the outcome measure for major trauma and for head injury. The enduring appeal of the GOS is linked to its simplicity, short administration time, reliability and validity, stability, flexibility of administration (face-to-face, over the telephone and by post), cost-free availability and ease of access. These benefits apply to other derivatives of the scale, including the Glasgow Outcome at Discharge Scale (GODS) and the GOS paediatric revision. The GOS was devised to provide an overview of outcome and to focus on social recovery. Since the initial development of the GOS, there has been an increasing focus on the multidimensional nature of outcome after head injury. This Review charts the development of the GOS, its refinement and usage over the past 40 years, and considers its current and future roles in developing an understanding of brain injury