Practices and Attitudes to Prevention of Travel-related Infectious Diseases in United Arab Emirates

Introduction: Among the United Arab Emirates (UAE) population more and more people now consider travelling abroad. This is potentially problematic because travelling enhances exposure between hosts and pathogens and so people that travel are putting their health at risk. This concern makes it necessary that public education is provided to inform people of the risks of travelling abroad so that such risks can be minimized. Guidelines and advice on travelling abroad are available and easily accessible but several studies have shown that travellers do not always follow such advice. In this study, the aim was to look into the practices and attitudes of UAE residents in relation to prevention of travel-related infectious diseases. Methods: A cross-sectional study was conducted from February to April 2015, in different emirates of the UAE. A self-administered anonymous questionnaire was developed based on material acquired from similar studies. The methodology applied quota sampling whereby adults above the age of 18 who’d travelled abroad in the past year were chosen from the seven emirates. The number of participants selected from each emirate was proportionate to the population size of each state. Results: A total of 385 questionnaires were completed. A remarkable 70% of respondents indicated that they had not taken on any precautionary measures prior to travel. Of greater interest was that only 21% of participants had taken advice on health prior to travel, while the outstanding majority 79% reported that they had not taken advice. The most common source of advice had been taken from family and friends among those who had taken advice at 41%, while only 15.4% had acquired it from specialized travel medicine clinics. High risk perception, spending more preparation time and travelling for longer durations were important factors that encouraged pretrial health consultation and undertook preventive measures. Conclusion: This study revealed that UAE residents had not taken adequate measures to prevent travel related infectious diseases. Despite the limitations of this study, it still provides sufficient data to improve public health intervention directed at encouraging travellers to acquire pre travel health consultation

Characteristics of fetal and maternal heart rate tracings during labor: A prospective observational study

BACKGROUND: Fetal well-being is assured during labor and delivery with the employment of electronic fetal heart monitoring (EFHM). In uncommon instances, maternal heart rate (MHR) instead of fetal heart rate (FHR) can be the source of signals on monitors (signal ambiguity) leading to erroneous interpretation and management. Information about MHR characteristics are comparatively inadequate. We aim to analyze and compare MHR and FHR characteristics during the first and second stages of labor. METHODS: A prospective cohort study was conducted in a single tertiary care center during a one year period. Fifty one healthy full term women with singleton pregnancies during labor were enrolled. Uterine contractions, MHR and FHR were recorded simultaneously during both stages of labor by monitors designed for twin gestation. RESULTS: When compared to FHR, MHR had significantly lower baseline rate during 1st and 2nd stages (p < 0.0001). It demonstrated also more marked beat-to-beat variability during both stages (p < 0.0001). MHR showed significantly more accelerations (p = 0.03 and p = 0.008) and less decelerations (p < 0.0001 and p = 0.021) during 1st and 2nd stages respectively. CONCLUSIONS: All characteristic parameters and patterns produced by FHR could be mimicked by MHR as well, though, at different frequencies. Understanding EFHM patterns suspected to be MHR artefacts and the employment of modern monitors that simultaneously obtain and display FHR and MHR can unmask ambiguity and avert related misinterpretation problems. Similar studies should be conducted in high-risk groups where the potential for fetal hypoxia/acidosis is increased.SCOPUS: ar.jDecretOANoAutActifinfo:eu-repo/semantics/publishe

How safe is high‐order repeat cesarean delivery? An 8‐year single‐center experience in Lebanon

Aim: To quantify the impact of the number of prior cesarean deliveries (CD) on operative complications and preterm birth. Then to investigate the presence of a threshold, beyond which complications tend to be disproportionately dangerous. Methods: This was a retrospective cohort observational study, where data corresponding to all CD done at our service, during an 8-year period, were collected and analyzed. In total, 1840 CD were performed. Patients were divided into five categories that corresponded to the number of CD. Primary outcome was the composite adverse maternal outcome, while preterm birth and individual complications were secondary outcomes. Results: The composite adverse maternal outcome, preterm birth, as well as all individual complications related to CD, except for placental abruption, showed a significant rise in frequency that paralleled the increase in the number of CD. Furthermore, this increase tended to be continuous as the number of CD increased, with an evident surge after the fourth. Conclusion: In our population, increasing number of prior CD was a risk factor for a parallel increase in the rate of composite adverse maternal outcome, preterm birth and almost all intraoperative complications attributable to CD. Decreasing exposure to such surgeries by limiting family size to four offspring should be considered seriously in patient counseling.SCOPUS: ar.jDecretOANoAutActifinfo:eu-repo/semantics/publishe

How safe is high-order repeat cesarean delivery? An 8-year single-center experience in Lebanon

Aim: To quantify the impact of the number of prior cesarean deliveries (CD) on operative complications and preterm birth. Then to investigate the presence of a threshold, beyond which complications tend to be disproportionately dangerous. Methods: This was a retrospective cohort observational study, where data corresponding to all CD done at our service, during an 8-year period, were collected and analyzed. In total, 1840 CD were performed. Patients were divided into five categories that corresponded to the number of CD. Primary outcome was the composite adverse maternal outcome, while preterm birth and individual complications were secondary outcomes. Results: The composite adverse maternal outcome, preterm birth, as well as all individual complications related to CD, except for placental abruption, showed a significant rise in frequency that paralleled the increase in the number of CD. Furthermore, this increase tended to be continuous as the number of CD increased, with an evident surge after the fourth. Conclusion: In our population, increasing number of prior CD was a risk factor for a parallel increase in the rate of composite adverse maternal outcome, preterm birth and almost all intraoperative complications attributable to CD. Decreasing exposure to such surgeries by limiting family size to four offspring should be considered seriously in patient counseling.SCOPUS: ar.jDecretOANoAutActifinfo:eu-repo/semantics/publishe

Clinical impact of COVID-19 on patients with cancer (CCC19): a cohort study

BACKGROUND: Data on patients with COVID-19 who have cancer are lacking. Here we characterise the outcomes of a cohort of patients with cancer and COVID-19 and identify potential prognostic factors for mortality and severe illness. METHODS: In this cohort study, we collected de-identified data on patients with active or previous malignancy, aged 18 years and older, with confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection from the USA, Canada, and Spain from the COVID-19 and Cancer Consortium (CCC19) database for whom baseline data were added between March 17 and April 16, 2020. We collected data on baseline clinical conditions, medications, cancer diagnosis and treatment, and COVID-19 disease course. The primary endpoint was all-cause mortality within 30 days of diagnosis of COVID-19. We assessed the association between the outcome and potential prognostic variables using logistic regression analyses, partially adjusted for age, sex, smoking status, and obesity. This study is registered with ClinicalTrials.gov, NCT04354701, and is ongoing. FINDINGS: Of 1035 records entered into the CCC19 database during the study period, 928 patients met inclusion criteria for our analysis. Median age was 66 years (IQR 57-76), 279 (30%) were aged 75 years or older, and 468 (50%) patients were male. The most prevalent malignancies were breast (191 [21%]) and prostate (152 [16%]). 366 (39%) patients were on active anticancer treatment, and 396 (43%) had active (measurable) cancer. At analysis (May 7, 2020), 121 (13%) patients had died. In logistic regression analysis, independent factors associated with increased 30-day mortality, after partial adjustment, were: increased age (per 10 years; partially adjusted odds ratio 1·84, 95% CI 1·53-2·21), male sex (1·63, 1·07-2·48), smoking status (former smoker vs never smoked: 1·60, 1·03-2·47), number of comorbidities (two vs none: 4·50, 1·33-15·28), Eastern Cooperative Oncology Group performance status of 2 or higher (status of 2 vs 0 or 1: 3·89, 2·11-7·18), active cancer (progressing vs remission: 5·20, 2·77-9·77), and receipt of azithromycin plus hydroxychloroquine (vs treatment with neither: 2·93, 1·79-4·79; confounding by indication cannot be excluded). Compared with residence in the US-Northeast, residence in Canada (0·24, 0·07-0·84) or the US-Midwest (0·50, 0·28-0·90) were associated with decreased 30-day all-cause mortality. Race and ethnicity, obesity status, cancer type, type of anticancer therapy, and recent surgery were not associated with mortality. INTERPRETATION: Among patients with cancer and COVID-19, 30-day all-cause mortality was high and associated with general risk factors and risk factors unique to patients with cancer. Longer follow-up is needed to better understand the effect of COVID-19 on outcomes in patients with cancer, including the ability to continue specific cancer treatments. FUNDING: American Cancer Society, National Institutes of Health, and Hope Foundation for Cancer Research

Clinical impact of COVID-19 on patients with cancer (CCC19): a cohort study

BackgroundData on patients with COVID-19 who have cancer are lacking. Here we characterise the outcomes of a cohort of patients with cancer and COVID-19 and identify potential prognostic factors for mortality and severe illness.MethodsIn this cohort study, we collected de-identified data on patients with active or previous malignancy, aged 18 years and older, with confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection from the USA, Canada, and Spain from the COVID-19 and Cancer Consortium (CCC19) database for whom baseline data were added between March 17 and April 16, 2020. We collected data on baseline clinical conditions, medications, cancer diagnosis and treatment, and COVID-19 disease course. The primary endpoint was all-cause mortality within 30 days of diagnosis of COVID-19. We assessed the association between the outcome and potential prognostic variables using logistic regression analyses, partially adjusted for age, sex, smoking status, and obesity. This study is registered with ClinicalTrials.gov, NCT04354701, and is ongoing.FindingsOf 1035 records entered into the CCC19 database during the study period, 928 patients met inclusion criteria for our analysis. Median age was 66 years (IQR 57-76), 279 (30%) were aged 75 years or older, and 468 (50%) patients were male. The most prevalent malignancies were breast (191 [21%]) and prostate (152 [16%]). 366 (39%) patients were on active anticancer treatment, and 396 (43%) had active (measurable) cancer. At analysis (May 7, 2020), 121 (13%) patients had died. In logistic regression analysis, independent factors associated with increased 30-day mortality, after partial adjustment, were: increased age (per 10 years; partially adjusted odds ratio 1·84, 95% CI 1·53-2·21), male sex (1·63, 1·07-2·48), smoking status (former smoker vs never smoked: 1·60, 1·03-2·47), number of comorbidities (two vs none: 4·50, 1·33-15·28), Eastern Cooperative Oncology Group performance status of 2 or higher (status of 2 vs 0 or 1: 3·89, 2·11-7·18), active cancer (progressing vs remission: 5·20, 2·77-9·77), and receipt of azithromycin plus hydroxychloroquine (vs treatment with neither: 2·93, 1·79-4·79; confounding by indication cannot be excluded). Compared with residence in the US-Northeast, residence in Canada (0·24, 0·07-0·84) or the US-Midwest (0·50, 0·28-0·90) were associated with decreased 30-day all-cause mortality. Race and ethnicity, obesity status, cancer type, type of anticancer therapy, and recent surgery were not associated with mortality.InterpretationAmong patients with cancer and COVID-19, 30-day all-cause mortality was high and associated with general risk factors and risk factors unique to patients with cancer. Longer follow-up is needed to better understand the effect of COVID-19 on outcomes in patients with cancer, including the ability to continue specific cancer treatments.FundingAmerican Cancer Society, National Institutes of Health, and Hope Foundation for Cancer Research

Microtubule-binding agents: a dynamic field of cancer therapeutics.

International audienceMicrotubules are dynamic filamentous cytoskeletal proteins composed of tubulin and are an important therapeutic target in tumour cells. Agents that bind to microtubules have been part of the pharmacopoeia of anticancer therapy for decades and until the advent of targeted therapy, microtubules were the only alternative to DNA as a therapeutic target in cancer. The screening of a range of botanical species and marine organisms has yielded promising new antitubulin agents with novel properties. In the current search for novel microtubule-binding agents, enhanced tumour specificity, reduced neurotoxicity and insensitivity to chemoresistance mechanisms are the three main objectives

Nutraceutical Potential of Apiaceae

Apiaceae family is large, with over 3.000 species worldwide cultivated for many purposes. Some plants in this family such as carrots, parsley, parsnip and celery are common vegetable crops, while other members like anise, caraway, coriander, cumin, fennel, lovage, angelica and dill are famous for their medicinal and aromatic properties. Usage of these plants is very popular in everyday diet because of their documented health benefits. Apiaceae are a very important source of phytochemicals – chemicals with biological activity. However, phytochemicals are non-nutritive plant chemicals, also called nutraceuticals. They are widely used for prevention, treatment or cure of conditions or diseases. Bioactive compounds with nutraceutical potential are polyphenolic compounds, polyacetylenes and terpenoids. The aim of this review is to represent selected plants of Apiaceae family currently used as nutraceuticals and describe their nutritional benefits