Anatomical Distribution Patterns of Peripheral Arterial Disease According to Patient Characteristics: A Unicentral Cohort Study

Ibrahim Abobaker Alghanimi,1 Abdulaziz Mohammad Al-Sharydah,1 Afnan Amro Alqutub,2 Nehal Zeidan,2 Fatimah Bukhamseen,2 Alzahra Alradhi,2 Aqilah Taleb Alqassab,2 Mohammed Saad Al-Aftan1 1Diagnostic and Interventional Radiology Department, King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal University, AlKhobar City, Eastern Province, Saudi Arabia; 2College of Medicine, King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal University, AlKhobar City, Eastern Province, Saudi ArabiaCorrespondence: Ibrahim Abobaker Alghanimi, Assistant Professor and Consultant of Radiology, Vascular and Interventional Radiologist, Faculty of Medicine, Imam Abdulrahman Bin Faisal University, Radiology Department, King Fahd Hospital of the University, Khobar City, Eastern Province, Saudi Arabia, Tel +138957999 Ext 2007, Email [email protected]: Peripheral arterial disease (PAD) is a common disease with multiple risk factors and affects patients worldwide. Several international studies have established correlations between anatomical topography/distribution of atherosclerosis and comorbidities in patients with PAD. In this cohort study, we aimed to analyze the patterns of atherosclerosis (site, distribution, and degree) in patients who underwent lower limb computed tomography angiography and arterial angiography by identifying the atherosclerotic plaque(s) that were possibly responsible for thrombi. Additionally, we aimed to determine any relationship between comorbidities and identified patterns.Patients and Methods: Between January 2015 and January 2021, we retrospectively recruited 140 patients at King Fahd Hospital of the University of Saudi Arabia. Data collected included patient characteristics, risk factors, and metabolic disorders, such as hypertension (HTN), diabetes mellitus (DM), dyslipidemia, and chronic kidney disease. Patients with incomplete records or unavailable radiological images were excluded.Results: The infrapopliteal territory was the most common segment that was affected. HTN, DM, and dyslipidemia were found in 81.4%, 77.9%, and 62.9% of patients, respectively. Correlation analyses revealed that DM was the only independent metabolic disorder associated with a PAD distribution pattern in the femoropopliteal segment (p=0.039), thus denoting distal involvement. No significant association was found between PAD distribution and the severity of stenosis.Conclusion: Segmental involvement in PAD varies with the risk factors and metabolic comorbidities present in patients. DM is an independent predictor of the anatomical distribution of PAD. The identification of such an anatomical distribution is paramount for screening procedures, early detection of disease, and prevention of complications, particularly limb amputation.Keywords: angiography, computed tomography, diabetes mellitus, peripheral arterial disease, stenosi

Rate and Causes of Unplanned Hospital Returns within 60 Days following Head and Neck Surgery

Introduction Unplanned hospital returns are frequent and may be preventable

An assessment of unstimulated salivary flow rate, IgA and clinical oral dryness among active and passive smokers

ObjectivesThe aim of this study was to assess the impact of smoking on the whole salivary flow rate (SFR), IgA levels and clinical oral dryness (COD) among active and passive smokers.Material and MethodsThe participants were categorized as active smokers (N = 54) or passive smokers (N = 163). Saliva was collected in tubes and placed in ice storage at –70°C. Salivary IgA levels were assessed in duplication using the enzyme linked immunosorbent assay (ELISA) method. Following the saliva sample collection, the subjects were assessed for COD using the COD score, SFR and caries. Chi-square test, the t-test and ANOVA were employed to compare the clinical impact of the smoking status associated with specific variables (smoking status, number of cigarettes, active caries, gender, age, COD score, IgA level and SFR). A p-value of 35 years age group (p < 0.05).ConclusionsThe study demonstrated significant differences in SFR, IgA and COD scores among the active and passive smokers. The number of cigarettes had a negative impact on saliva production, IgA levels, the oral health status, and the progression of caries with respect to age and gender. Smoking potentially leads to xerostomia associated with active caries

Assessment of Unstimulated Whole Salivary Tumor Necrosis Factor Alpha (TNF-α) and Cellular Micronuclei Levels in Snuff (Naswar) Users and Non-Users for Early Diagnosis of Oral Squamous Cell Carcinoma

The aim of the study was to investigate the unstimulated whole saliva (UWS) tumor necrosis factor alpha (TNF-α) and cellular micronuclei in snuff dippers (Naswar) compared to healthy control subjects. The case control study was conducted over 9 months at a tertiary care center. Sixty patients were divided into two groups: Snuff dippers (SD) (Naswar) and non-snuff dippers (NSD) (control subjects). The included self-reported SD used Snuff twice daily for more than 12 months. UWS was collected and salivary TNF-α assessment was performed using enzyme-linked immunosorbent assay (ELISA). For cellular micronuclei, buccal mucosa was brushed to obtain cells in Naswar users, fixed with a dibutylphthalate polystyrene xylene (DPX) mounting to view micronuclei. Means and standard deviations were compared using the t-test and outcomes were related using Pearson correlation, considering p ≤ 0.05 as significant. The mean age of participants was 38.85 ± 11.56 years. The mean duration of snuff use was 20.43 ± 12.79 years and the common site for Naswar placement was the lower vestibule (n = 19, 63.3%). TNF-α levels among SD were 9.6 ± 3.3 pg/mL, which were significantly higher than levels in NSD, 5.2 ± 3 pg/mL (p &lt; 0.05). The number of cellular micronuclei in SD was 30.7 ± 7.8, which was comparatively higher than in NSD, which was 9.2 ± 3.3 (p &lt; 0.05). The duration of snuff use was positively correlated to TNF-α levels (p = 0.048) rather than the micronuclei number (p = 0.97). SD showed higher levels of TNF-α and cellular micronuclei compared with NSD (control subjects); a positive correlation was shown with the duration of snuff use. We conclude that TNF-α and micronuclei are potential salivary biomarkers for an oral biological effect in snuff (Naswar) users

Table_1_Higher carbohydrate intake in relation to non-alcoholic fatty liver disease in patients with type 2 diabetes.docx

BackgroundNon-alcoholic fatty liver disease (NAFLD) is an overlooked complication of type 2 diabetes (T2D). Current recommendations for the management of NAFLD are mainly focused on weight reduction, overlooking the role of macronutrient composition. Although dietary carbohydrates play a major role in intrahepatic fat synthesis, their association with the progression of liver steatosis has not been fully investigated in patients with T2D.AimTo investigate the association between higher carbohydrate intake and the presence of liver steatosis in patients with T2D.MethodsThis cross-sectional study included men and women aged 18–60 years diagnosed with T2D. Anthropometric measurements, hepatic steatosis assessment using the controlled attenuation parameter (CAP), blood samples, and dietary data were analyzed. Participants were divided into two groups: NAFLD and NAFLD-free. A two-sample t-test was used to evaluate the differences between the two groups. Stepwise multiple linear regression models adjusted for potential confounders were used to determine the association between CAP values and higher carbohydrate intake.ResultsIn total, 358 participants were included. NAFLD was present in 79.3% of the participants. Body mass index, waist circumference, ALT, HbA1c, and triglycerides showed direct, while HDL-Cholesterol revealed inverse associations with CAP values. No significant relationship was found between carbohydrate intake and steatosis in the total study sample; however, multiple linear regression analysis revealed a significant relationship between carbohydrate intake and CAP values in patients aged ≤50 years.ConclusionIn patients with T2D, higher carbohydrate intake was associated with liver steatosis in those aged 50 years and below. Further studies are required to confirm the causality between carbohydrate intake and liver steatosis.</p

Strategies to manage hepatitis C virus infection disease burden - volume 3.

To access publisher's full text version of this article click on the hyperlink at the bottom of the pageThe hepatitis C virus (HCV) epidemic was forecasted through 2030 for 15 countries in Europe, the Middle East and Asia, and the relative impact of two scenarios was considered: increased treatment efficacy while holding the annual number of treated patients constant and increased treatment efficacy and an increased annual number of treated patients. Increasing levels of diagnosis and treatment, in combination with improved treatment efficacy, were critical for achieving substantial reductions in disease burden. A 90% reduction in total HCV infections within 15 years is feasible in most countries studied, but it required a coordinated effort to introduce harm reduction programmes to reduce new infections, screening to identify those already infected and treatment with high cure rate therapies. This suggests that increased capacity for screening and treatment will be critical in many countries. Birth cohort screening is a helpful tool for maximizing resources. Among European countries, the majority of patients were born between 1940 and 1985. A wider range of birth cohorts was seen in the Middle East and Asia (between 1925 and 1995).Gilead Sciences Center for Disease Analysi

Borislav Runanine as the Friend of the Prince (centre), Tamara Toumanova as the Queen of the Swans (centre), Paul Petroff as the Prince (centre right), and artists of the company, in Le lac des cygnes, the Original Ballet Russe, Australian tour, His Majesty's Theatre, Melbourne, 1940 [picture] /

From: Le lac des cygnes (Swan lake) : choreographic poem in one act / music by Peter Ilich Tchaikovsky; Part of the collection: Hugh P. Hall collection of photographs, 1938-1940.; Performed March and April 1940. No number on front. 3P/9 on reverse.; Choreography after M. Petipa ; scenery and costumes by C. Korovine ; scenery executed by O. Allegri.; Also available in an electronic version via the internet at: http://nla.gov.au/nla.pic-vn4175672. One of a collection of photographs taken by Hugh P. Hall of 28 ballet productions performed by the Covent Garden Russian Ballet (toured Australia 1938-1939) and the Original Ballet Russe (toured Australia 1939-1940). These are the second and third of the three Ballets Russes companies which toured Australasia between 1936 and 1940. The photographs were taken from the auditorium during a live performance in His Majesty's Theatre, Melbourne and mounted on cardboard for display purposes. For conservation and storage, the photographs have been demounted. The original arrangement of the photographs has been recorded, and details are available from the Pictures Branch of the National Library

Historical epidemiology of hepatitis C virus (HCV) in select countries - volume 3.

To access publisher's full text version of this article click on the hyperlink at the bottom of the pageDetailed, country-specific epidemiological data are needed to characterize the burden of chronic hepatitis C virus (HCV) infection around the world. With new treatment options available, policy makers and public health officials must reconsider national strategies for infection control. In this study of 15 countries, published and unpublished data on HCV prevalence, viraemia, genotype, age and gender distribution, liver transplants and diagnosis and treatment rates were gathered from the literature and validated by expert consensus in each country. Viraemic prevalence in this study ranged from 0.2% in Iran and Lebanon to 4.2% in Pakistan. The largest viraemic populations were in Pakistan (7 001 000 cases) and Indonesia (3 187 000 cases). Injection drug use (IDU) and a historically unsafe blood supply were major risk factors in most countries. Diagnosis, treatment and liver transplant rates varied widely between countries. However, comparison across countries was difficult as the number of cases changes over time. Access to reliable data on measures such as these is critical for the development of future strategies to manage the disease burden.Gilead Sciences Center for Disease Analysi