Neutrophil chemokines levels in different stages of nephrotic syndrome

Nephrotic syndrome (NS) is a disease of glomerular filtration barrier failure presenting with variable degrees of proteinuria, hypoalbuminemia, hyperlipidemia, and edema. Inflammation may contribute to the pathogenesis of NS. The aim of this study was to monitor the serum levels of three cytokines [i.e., granulocyte chemotactic protein-2 (GCP-2), growth-related oncogene-α (GRO-α), and interleukin-8 (IL-8)] in different stages of NS and to find out whether changes in the levels of these cytokines could be related to the severity of NS. This study included 125 patients who were divided into 40 patients with nephrotic range proteinuria (NRP), 45 patients with NS, and 40 patients who were in remission. This study also included 80 healthy participants as a control group. Enzyme-linked immunosorbent assay was used for the determination of the plasma levels of GRO-α, GCP-2, and IL-8. GCP-2 plasma levels were significantly higher in the NS and NRP groups when compared to the control group, whereas the GRO-α and IL-8 levels were significantly higher in all patient groups in comparison with the control group. All these chemokine levels were significantly decreased in remission as compared with the participants in the NS group (P <0.0001). There was a significant correlation between the cytokine levels and proteinuria and serum albumin in the NS group (P <0.0001). However, in the follow-up group, GCP-2 levels were significantly lower during remission as compared to those with active NS (P <0.0001). Our findings suggest that the pro-inflammatory cytokines GCP-2, GRO-α, and IL-8 could play a role in the pathogenesis of NS, particularly glomerular permeability

Thrombin generation and endothelial dysfunctional markers in different stages of nephrotic syndrome

Objectives: Venous thromboembolism is an important and potentially life-threatening complication of nephrotic syndrome (NS). This study aims to evaluate the functional test of thrombin generation (TG) in different stages of NS; determine its relation with the coagulation screening tests (prothrombin time [PT] and activated partial thromboplastin time), hemostatic activation markers (thrombin–antithrombin complex [TAT] and prothrombin fragment 1+2 [PF1+2]), and von Willebrand factor (vWF) and its proteolytic enzyme ADAMTS-13; and determine the correlation between TG and NS severity, as reflected by the levels of proteinuria and albumin. Materials and Methods: This case–control cross-sectional study included 125 patients (n = 40, nephrotic range proteinuria; n = 45, NS; n = 40, remission) and 80 controls. Calibrated automated thrombogram assay (endogenous thrombin potential [ETP]) was performed to determine TG. TAT, PF1+2, vWF, and ADAMTS-13 were measured using enzyme-linked immunosorbent assay. Results: TG (ETP), TAT, PF1+2, and vWF levels were significantly higher in all of the patient groups (P < 0.0001) than in the control group. ADAMTS-13 levels were significantly lower in the NS group (P < 0.0001) than in the control group. Conclusion: Our findings confirm activation of the coagulation pathway in nephrotic patients. However, the degree of hypercoagulopathy (especially TG [ETP]) is positively correlated with proteinuria. Proteinuria could be considered an indirect indicator of the highest risk of thrombotic disease in patients with NS

A Novel Machine-Learning-Based Hybrid CNN Model for Tumor Identification in Medical Image Processing

The popularization of electronic clinical medical records makes it possible to use automated methods to extract high-value information from medical records quickly. As essential medical information, oncology medical events are composed of attributes that describe malignant tumors. In recent years, oncology medicine event extraction has become a research hotspot in academia. Many academic conferences publish it as an evaluation task and provide a series of high-quality annotation data. This article aims at the characteristics of discrete attributes of tumor-related medical events and proposes a medical event. The standard extraction method realizes the combined extraction of the primary tumor site and primary tumor size characteristics, as well as the extraction of tumor metastasis sites. In addition, given the problems of the small number and types of annotation texts for tumor-related medical events, a key-based approach is proposed. A pseudo-data-generation algorithm that randomly replaces information in the whole domain improves the transfer learning ability of the standard extraction method for different types of tumor-related medical event extractions. The proposed method won third place in the clinical medical event extraction and evaluation task of the CCKS2020 electronic medical record. A large number of experiments on the CCKS2020 dataset verify the effectiveness of the proposed method

A Novel Machine-Learning-Based Hybrid CNN Model for Tumor Identification in Medical Image Processing

The popularization of electronic clinical medical records makes it possible to use automated methods to extract high-value information from medical records quickly. As essential medical information, oncology medical events are composed of attributes that describe malignant tumors. In recent years, oncology medicine event extraction has become a research hotspot in academia. Many academic conferences publish it as an evaluation task and provide a series of high-quality annotation data. This article aims at the characteristics of discrete attributes of tumor-related medical events and proposes a medical event. The standard extraction method realizes the combined extraction of the primary tumor site and primary tumor size characteristics, as well as the extraction of tumor metastasis sites. In addition, given the problems of the small number and types of annotation texts for tumor-related medical events, a key-based approach is proposed. A pseudo-data-generation algorithm that randomly replaces information in the whole domain improves the transfer learning ability of the standard extraction method for different types of tumor-related medical event extractions. The proposed method won third place in the clinical medical event extraction and evaluation task of the CCKS2020 electronic medical record. A large number of experiments on the CCKS2020 dataset verify the effectiveness of the proposed method

Federated Learning Approach to Protect Healthcare Data over Big Data Scenario

The benefits and drawbacks of various technologies, as well as the scope of their application, are thoroughly discussed. The use of anonymity technology and differential privacy in data collection can aid in the prevention of attacks based on background knowledge gleaned from data integration and fusion. The majority of medical big data are stored on a cloud computing platform during the storage stage. To ensure the confidentiality and integrity of the information stored, encryption and auditing procedures are frequently used. Access control mechanisms are mostly used during the data sharing stage to regulate the objects that have access to the data. The privacy protection of medical and health big data is carried out under the supervision of machine learning during the data analysis stage. Finally, acceptable ideas are put forward from the management level as a result of the general privacy protection concerns that exist throughout the life cycle of medical big data throughout the industry

Foreign–trained medical professionals: Wanted or not? A case study of Canada

Definitions of the term “International Medical Graduate” vary but the Medical Council of Canada defines an IMG to be a graduate of a medical school outside of Canada or the United States, with the exception of US schools of osteopathic medicine

Federated Learning Approach to Protect Healthcare Data over Big Data Scenario

The benefits and drawbacks of various technologies, as well as the scope of their application, are thoroughly discussed. The use of anonymity technology and differential privacy in data collection can aid in the prevention of attacks based on background knowledge gleaned from data integration and fusion. The majority of medical big data are stored on a cloud computing platform during the storage stage. To ensure the confidentiality and integrity of the information stored, encryption and auditing procedures are frequently used. Access control mechanisms are mostly used during the data sharing stage to regulate the objects that have access to the data. The privacy protection of medical and health big data is carried out under the supervision of machine learning during the data analysis stage. Finally, acceptable ideas are put forward from the management level as a result of the general privacy protection concerns that exist throughout the life cycle of medical big data throughout the industry

Is the outcome of childhood acute myeloid leukemia with t(8;21) inferior in Saudi Arabia? A multicenter SAPHOS leukemia group study

Background: Despite the confirmed favorable prognosis of childhood t(8;21) acute myeloid leukemia (AML), recent reports suggest heterogeneity in survival outcomes in this subtype of AML may be influenced by ethnicity. Therefore, we aimed to assess the outcome of childhood t(8;21) AML in an Arab population to evaluate if survival outcomes were inferior and determine the predictive relevance of additional cytogenetic abnormalities. Methods: This multicenter retrospective study analyzed 175 de novo AML children of 14 years of age or younger consecutively diagnosed between January 2005 and December 2012. Survival outcomes were analyzed and patients with t(8;21) were stratified on the basis of karyotype into sole and additional cytogenetic groups. Results: A total of 33 (18.9%) patients had t(8;21) AML. Complete remission (CR) was achieved in 31 (93.9%) patients. The 5-year overall survival, event-free survival, cumulative incidence of relapse (CIR), and remission death rates were 59.9 ± 9.2, 45.6 ± 9.1, 36.4, and 9.1%, respectively. Despite the administration of hematopoietic stem-cell-transplant salvage therapy in first relapse, five out of 11 (45.5%) relapsed patients died of disease. Subanalysis of sole vs. additional cytogenetic abnormalities revealed no significant difference in outcome. Conclusion: In the present study, childhood t(8;21) AML was associated with inferior survival and resistance to salvage therapy compared to reports from international groups. The inferior outcomes were unrelated to additional cytogenetic abnormalities. Further detailed genetic studies are warranted to unmask the biological and clinical differences between racial/ethnic groups. Given the high CR rate of childhood t(8;21) AML, further modification of postremission therapy to improve the CIR rate is needed

Community Pharmacists role in obesity treatment in Kuwait: a cross-sectional study

<p>Abstract</p> <p>Background</p> <p>Obesity is a growing health concern in Kuwait. Obesity has been identified as a key risk factor for many chronic diseases including hypertension, dyslipidemia and type 2 diabetes mellitus. It has been shown that community pharmacists' involvement is associated with successful weight management in developed countries. This study was conducted to investigate the role of community pharmacists in obesity counseling, and to identify the barriers to counseling in Kuwait.</p> <p>Methods</p> <p>A descriptive cross-sectional study involved 220 community pharmacies that were selected via stratified and systematic random sampling. A pretested self-administered questionnaire collected information on frequency and comfort level with obesity counseling, and the perceived effectiveness of four aspects of obesity management (diet and exercise, prescribed antiobesity medications, diet foods, and nonprescription products and dietary supplements). Information on perceived confidence in achieving positive outcomes as a result of counseling and barriers to counseling was also collected. Descriptive and Spearman’ r analysis were conducted using SPSS version 17. Responses with Likert scale rating 1(low score) to 5 (high score) and binary choices (yes/no) were presented as mean (SD) and (95% CI), respectively.</p> <p>Results</p> <p>The response rate was 93.6%. The overall mean (SD) responses indicated that pharmacists counseled obese patients sometimes to most of the time, 3.67 (1.19) and were neutral to comfortable with counseling about aspects of obesity management, 3.77 (1.19). Respondents perceived obesity management aspects to be somewhat effective, 3.80 (1.05). Of the four aspects of obesity management, diet and exercise, and diet foods were the highest ranked in terms of frequency of counseling, comfort level and perceived effectiveness. Pharmacists were neutral to confident in achieving positive outcomes as a result of obesity counseling, 3.44 (1.09). Overall mean responses of counseling obese patients by pharmacists were positively correlated with their perceived comfort with counseling and perceived effectiveness of obesity management aspects. The most anticipated barriers to obesity counseling were lack of patient awareness about pharmacists' expertise in counseling 76.2% (95% CI: 69.7-81.7) and pharmacists’ opinions that obese patients lack willpower and are non-adherent to weight reduction interventions 71.8% (95% CI: 65.1-77.8).</p> <p>Conclusions</p> <p>Strengths, weaknesses and barriers related to obesity counseling by pharmacists in Kuwait were identified, and suggestions were provided to strengthen that role.</p