Predictive model of coronary heart disease in Egypt (a disease with multiple risk factors)

As a multifactorial disease and with the need of primordial prevention coronary heart disease (CHT), a risk scoring system for the prediction of CHD was devised at Community Medicine Department Ain Shams University, Cairo, EGYPT. In this matched case-control study of 119 cases and 121 age and sex matched controls, current cigarette smoking, lack of siesta, hypertension, diabetes mellitus, low occupational physical activity, hypercholesterolemia, marital status, urban residence, level of education, work index, coffee consumption, positive family history, BMI, elevated W/H ratio, low HDL and elevated TC/HDL were studied for association with CHD. The additive risk scoring system based on the results of conditional multiple logistic regression identified the first six factors with statistical weights of 1, 5, 10, 6, 6, 11, respectively. On back validation receiver operating characteristic (ROC) curve, a total score of 17 was found to be the cut off point above which there was increased risk of CHD. The overall predictive accuracy of this system--equivalent to the area under the ROC curve--was 0.873. Future studies need to assess the risk scoring system in population based studies.     

Is the preoperative radiograph useful in predicting the outcome of a total hip replacement?

The preoperative radiographs of 1015 patients undergoing 1163 total hip replacements for osteoarthritis were evaluated to determine if a relationship exists between the extent of osteoarthritis and the clinical results of a total hip replacement. Preoperative radiographs were graded with respect to the degree of cartilage space loss, direction of cartilage space loss (femoral head migration), and severity of osteophyte formation. Followup averaged 32.1 months (range, 6-93 months). Greater degrees of cartilage space loss correlated with lower hip scores preoperatively but were unrelated to preoperative pain. These patients had statistically less pain at 6 months and 1 year. Patients with superior cartilage space loss before surgery also had statistically less pain at 6 months. However, at 3 years and beyond, pain was independent of degree of preoperative cartilage space loss, osteophyte formation, or femoral head migration. In addition, hip scores at any followup were independent of the degree of osteoarthritis observed on the preoperative radiograph. These findings provide statistical support to the concept that greater degrees of joint space loss correlate with better relief of pain and less severe joint space loss correlates with less relief of pain within the first year after total hip replacement. At 3 years and beyond, hip and pain scores were independent of the degree of preoperative osteoarthritis.     

Knowledge and Attitudes of Saudi Dental Undergraduates on Oral Cancer

Oral cancer awareness among future dental practitioners may have an impact on the early detection and prevention of oral cancer. A cross-sectional survey was undertaken to assess the current knowledge of future Saudi dentists on oral cancer and their opinions on oral cancer prevention. A pretested questionnaire was sent to 550 undergraduate dental students in the fourth, fifth, and sixth year of the Al-Farabi College for Dentistry and Nursing, Riyadh, Saudi Arabia. Questions relating to knowledge of oral cancer, risk factors, and opinions on oral cancer prevention and practices were posed. Four hundred seventy-nine students returned the questionnaire (87.1 %). Eighty-one percent of respondents correctly answered questions relating to oral cancer awareness. Eighty-seven percent of respondents felt confident in performing a systematic oral examination to detect changes consistent with oral malignancy. Interestingly, 57 % of respondents had seen the use of oral cancer diagnostics aids. Thirty-seven percent of respondents felt inadequately trained to provide tobacco and alcohol cessation advice. There is a need to reinforce the undergraduate dental curriculum with regards to oral cancer education; particularly in its prevention and early detection. Incorporating the use of oral cancer diagnostic aids should be made mandatory.     

Using the cardiac depression scale in men recovering from coronary artery bypass surgery

Aims. To examine the utility and validate the use of the Cardiac Depression Scale in patients who had first‐time coronary artery bypass graft surgery. Background. The Beck Depression Inventory, though frequently used, may not be sufficiently sensitive for use in cardiac patients. The Cardiac Depression Scale has been shown to identify the range of depression in medical cardiac patients. Design. Survey. Methods. The Beck Depression Inventory and Cardiac Depression Scale were administered to 120 men at hospital discharge, as well as six, 12 and 36 weeks postoperatively. Cronbach’s α scores were calculated for the measures at each point. Changes in scores over time were analysed using repeated measures analysis of variance. Associations between the measures scores were calculated using Pearson product–moment correlations. Agreement between the measures’ dichotomised scores (depression/no depression) was examined using Cohen’s Kappa statistic. Results. Internal consistency was similar for the Beck Depression Inventory (0·793–0·904) and Cardiac Depression Scale (0·859–0·910). Depression scores decreased over time with the Beck Depression Inventory [F(2·50, 175·29) = 22·27, p < 0·001] and Cardiac Depression Scale [F(2·68, 190·37) = 13·18, p < 0·001]. The measures had similar power [Cohen’s f = 0·65 (Beck Depression Inventory) and 0·43 (Cardiac Depression Scale)] to reveal changes over time. The continuous scores were highly correlated at each point [0·737 (p < 0·001)–0·819 (p < 0·001)]. However, when dichotomised scores were compared, the chance corrected level of agreement was less impressive [0·198 (p = 0·014)–0·381 (p < 0·001)]. Conclusions. The Cardiac Depression Scale may have utility for use with surgical cardiac patients. However, continued examination of this measure of depression is warranted. Relevance to clinical practice. Given the prevalence of depression and its negative impact on coronary artery disease, it is important to identify even mild depression in cardiac patients. Using a measure of depression specifically for cardiac patients, rather than a generic measure, may best accomplish this goal.     

Eating habits are associated with subjective sleep quality outcomes among university students: findings of a cross-sectional study

Sleep and Breathing - This study investigated the relationships between eating habits and sleep quality among university students. In a cross-sectional study, university students completed a...     

Cardiac resynchronization devices: the Food and Drug Administration's regulatory considerations

Cardiac resynchronization therapy (CRT) devices have been studied clinically since 1998, and have been on the U.S. market since the Food and Drug Administration (FDA) approval of the first product in 2001. Since that time, the FDA has approved many different models from three different manufacturers, representing the first and second generations of these products. All of these products have undergone the FDA pre-market approval process, which examines the safety and effectiveness of the devices for their intended use. Over the last several years, the FDA has adapted recommendations for CRT clinical trials based on an evolving understanding of what these devices can achieve. This paper will outline the dynamic nature of the FDA's approval process for CRT devices and briefly review the clinical trial designs for the first generation devices.