Characteristics,evolution, and outcome of patients with non-infectious uveitis referred for rheumatologic assessment and management: an Egyptian multicenter retrospective study

Clinical Rheumatology - To investigate the characteristics, evolution, and visual outcome of non-infectious uveitis. Records of 201 patients with non-infectious uveitis (136 (67.7%) males and 84...     

Prognostic Impact of Serum Growth Differentiation Factor 15 Level in Acute Myeloid Leukemia Patients

Growth differentiation factor 15 (GDF15) plays an important role in cancer pathophysiology and prognosis. However, limited studies analyzed its level and prognostic value in acute myeloid leukemia (AML) patients. This study included 56 adult AML patients. Serum GDF15 level was measured at diagnosis in all patients by enzyme-linked immunosorbent assay. Remission and survival statuses were assessed at 90 days following treatment. GDF15 level was significantly higher in patients than in controls (P < 0.001). GDF15 level correlated positively with age (P < 0.001), hemoglobin level (P = 0.027), and platelet count (P = 0.024). High GDF15 above the median level was associated with inferior OS (P = 0.044) together with high platelet count (P = 0.006) and high bone marrow blast percent (P = 0.038). There was no statistically significant difference between patients with GDF15 above and below the median level regarding DFS (P = 0.881). On multivariate analysis for OS, GDF15 level was an independent risk factor (P = 0.047). In conclusion, serum GDF15 level is significantly elevated in AML patients and high GDF15 level is associated with inferior OS.     

HIV Prevalence and Related Behaviors Among People Who Inject Drugs in Iran from 2010 to 2020

AIDS and Behavior - Injection drug use has been the leading route of HIV transmission in Iran. We assessed HIV prevalence, risk behaviors, and uptake of prevention services among people who inject...     

Outcomes after rectosigmoid resection for endometriosis: a systematic literature review

Purpose

“Endometriosis” is defined such as the presence of endometrial glands and stroma outside the uterine cavity. This ectopic condition may develop as deeply infiltrating endometriosis (DIE) when a solid mass is located deeper than 5 mm underneath the peritoneum including the intestinal wall. The ideal surgical treatment is still under search, and treatment may range from simple shaving to rectal resection. The aim of the present systematic review is to report and analyze the postoperative outcomes after rectosigmoid resection for endometriosis.

Methods

We performed a systematic review according to Meta-analysis of Observational Studies in Epidemiology guidelines. The search was carried out in the PubMed database, using the keywords: “rectal resection” AND “endometriosis” and “rectosigmoid resection” AND “endometriosis.” The search revealed 380 papers of which 78 were fully analyzed.

Results

Thirty-eight articles published between 1998 and 2017 were included. Three thousand seventy-nine patients (mean age 34.28?±?2.46) were included. Laparoscopic approach was the most employed (90.3%) followed by the open one (7.9%) and the robotic one (1.7%). Overall operative time was 238.47?±?66.82. Conversion rate was 2.7%. In more than 80% of cases, associated procedures were performed. Intraoperative complications were observed in 1% of cases. The overall postoperative complications rate was 18.5% (571 patients), and the most frequent complication was recto-vaginal fistula (74 patients, 2.4%). Postoperative mortality rate was 0.03% and mean hospital stay was 8.88?±?3.71 days.

Conclusions

Despite the large and extremely various number of associated procedures, rectosigmoid resection is a feasible and safe technique to treat endometriosis.

     

99mTc‐(EDDA/tricine)‐HYNIC‐GnRH analogue as a potential imaging probe for diagnosis of prostate cancer

Prostate cancer is a serious threat to men's health, so it is necessary to develop the techniques for early detection of this malignancy. Radiolabeled peptides are the useful tools for diagnosis of prostate cancer. In this research, we designed a new HYNIC‐conjugated GnRH analogue and labeled it by ^99mTc with tricine/EDDA as coligands. We used aminohexanoic acid (Ahx) as a hydrocarbon linker to generate ^99mTc‐(tricine/EDDA)‐HYNIC‐Ahx‐[DLys⁶]GnRH. The radiopeptide exhibited high radiochemical purity and stability in solution and serum. Two human prostate cancer cell lines LN‐CaP and DU‐145 were used for cellular experiments. The binding specificity and affinity of radiopeptide for LN‐CaP were superior to DU‐145 cells. The K_d values for LN‐CaP and DU‐145 cells were 41.91 ± 7.03 nM and 55.96 ± 10.56 nM, respectively. High kidney uptake proved that the main excretion route of radiopeptide was through the urinary system. The tumor/muscle ratio of ^99mTc‐HYNIC‐Ahx‐[DLys⁶]GnRH was 4.14 at 1 hr p.i. that decreased to 2.41 at 4 hr p.i. in LN‐CaP tumor‐xenografted nude mice. The blocking experiment revealed that the tumor uptake was receptor‐mediated. The lesion was visualized clearly using ^99mTc‐[DLys⁶]GnRH at 1 hr p.i. Accordingly, this research highlights the capability of ^99mTc‐(tricine/EDDA)‐HYNIC‐Ahx‐[DLys⁶]GnRH peptide as a promising agent for GnRHR‐expressing tumor imaging.     

Impact of IL12B Gene rs 3212227 Polymorphism on Fibrosis,Liver Inflammation,and Response to Treatment in Genotype 4 Egyptian Hepatitis C Patients

Introduction. Hepatitis C virus (HCV) infection affects almost 3% of the world''s population with the highest prevalence in Egypt (15%). The standard therapy; pegylated interferon (PEG-IFN) and ribavirin, is effective in only 60% of Egyptian patients; moreover it is costly, prolonged, and has severe side effects, so prediction of response is essential to reduce burden of unfavorable treatment. Several viral and host factors have been proved to affect response to the treatment PEG-IFN and ribavirin; the strongest of them is polymorphisms near IL28B; nonetheless, nonresponse in patients with favorable IL28B is still unexplained, which implies the importance of studying other immunological factors that may correlate with response. Interleukin 12 (IL-12) is one of the most important proinflammatory cytokine presented with the initiation of immune response, determining Th1 and Th2 differentiation. A functional single nucleotide polymorphism (A/C) at the 3′ untranslated region (3′UTR) at position 1188 (NCBI SNP database no 3212227) was reported to be associated with responding more efficiently to antiviral combination therapy in HCV genotype 1 infected patients. The present study aims to evaluate association between this polymorphism with fibrosis stages, necroinflammation activity, response to the combined therapy, and gender in Egyptian HCV genotype 4. Material and Methods. A total of 133 Egyptian chronic HCV (CHCV) patients were treated with IFN/RBV and were followed up. IL12B 1188 A/C genotyping was performed using polymerase chain reaction-restriction fragment length polymorphism (PRC-RFLP) analysis. Results. A nonsignificant trend for higher sustained virological response (SVR) was observed in patients homozygote for IL12B 1188 A/C SNP CC genotype (69% SVR versus 30.8% NR) only but not in AC and AA genotypes. No association was detected between IL12B 1188 A/C polymorphism and less severe fibrosis or less liver activity. By stratification of response according to gender genotype, a significant difference in response between males and females was seen among AA genotype carriers only due to high number of non responder females. Conclusion. IL12B CC genotype appears to have some influence on SVR achievement but not on severe fibrosis and severe necroinflamation activity. Females carrying A/A genotype of IL12B 1188 A/C SNP achieve less SVR than those carrying AC and CC genotypes.     

Current Advances in Endovascular Treatment of Intracranial Atherosclerotic Disease and Future Prospective

Objectives/BackgroundMedical therapy is the first line of treatment for intracranial atherosclerotic disease (ICAD). Percutaneous transluminal angioplasty and stenting (PTAS) are mainly considered for those patients with severe stenosis and recurrent events despite aggressive medical therapy. In this review, we discuss the application of PTAS as a treatment option for ICAD and its future prospect.Materials and MethodsWe did the literature review of the key articles and guidelines to elaborate on the role of PTAS in the management of ICAD based on the current data and expert opinion. We searched PubMed, Google Scholar, and Scopus up to August 2020, and included articles published only in the English language.ResultsSince the publication of the results from SAMMPRIS and VISSIT trials, stenting is no longer recommended for secondary stroke prevention in patients with symptomatic ICAD. However, recent clinical studies on intracranial stenting for a subgroup of ICAD patients have shown promising results, likely due to better patient selection and continued advancement of endovascular techniques.ConclusionThere exists a lack of consensus regarding the best endovascular treatment approach (e.g., angioplasty alone or balloon mounted stent vs. self-expanding stent with or without prior angioplasty) or management of in-stent restenosis. Another area of clinical controversy relates to the ideal use and duration of antiplatelet therapy.     

Artificial Intelligence for Fast and Accurate 3-Dimensional Tooth Segmentation on Cone-beam Computed Tomography

IntroductionTooth segmentation on cone-beam computed tomographic (CBCT) imaging is a labor-intensive task considering the limited contrast resolution and potential disturbance by various artifacts. Fully automated tooth segmentation cannot be achieved by merely relying on CBCT intensity variations. This study aimed to develop and validate an artificial intelligence (AI)-driven tool for automated tooth segmentation on CBCT imaging.MethodsA total of 433 Digital Imaging and Communications in Medicine images of single- and double-rooted teeth randomly selected from 314 anonymized CBCT scans were imported and manually segmented. An AI-driven tooth segmentation algorithm based on a feature pyramid network was developed to automatically detect and segment teeth, replacing manual user contour placement. The AI-driven tool was evaluated based on volume comparison, intersection over union, the Dice score coefficient, morphologic surface deviation, and total segmentation time.ResultsOverall, AI-driven and clinical reference segmentations resulted in very similar segmentation volumes. The mean intersection over union for full-tooth segmentation was 0.87 (±0.03) and 0.88 (±0.03) for semiautomated (SA) (clinical reference) versus fully automated AI-driven (F-AI) and refined AI-driven (R-AI) tooth segmentation, respectively. R-AI and F-AI segmentation showed an average median surface deviation from SA segmentation of 9.96 μm (±59.33 μm) and 7.85 μm (±69.55 μm), respectively. SA segmentations of single- and double-rooted teeth had a mean total time of 6.6 minutes (±76.15 seconds), F-AI segmentation of 0.5 minutes (±8.64 seconds, 12 times faster), and R-AI segmentation of 1.2 minutes (±33.02 seconds, 6 times faster).ConclusionsThis study showed a unique fast and accurate approach for AI-driven automated tooth segmentation on CBCT imaging. These results may open doors for AI-driven applications in surgical and treatment planning in oral health care.     

Glauconite clay-functionalized chitosan nanocomposites for efficient adsorptive removal of fluoride ions from polluted aqueous solutions

We herein have developed a mild approach for the fabrication of glauconite clay (G)-modified chitosan (CS) nanocomposites by the combination of a simple blending and crosslinking method. The chitosan was modified with ethylenediaminetetraacetic acid (EDTA), glutaraldehyde (GL), sodium dodecyl sulfate (SDS), and cetyltrimethyl ammonium bromide (CTAB). The as-prepared composites were identified using Fourier-transform infrared spectroscopy (FTIR), X-ray diffraction (XRD), field emission scanning electron microscopy (FE-SEM), nitrogen physical adsorption (BET), atomic absorption spectrophotometry (AA), and thermal gravimetric analysis (TGA). The adsorption activities of the as-prepared materials were assessed for the removal of fluoride ions from aqueous media using a batch technique. Raw glauconite (G), GL-CS/G, SDS-CS/G, EDTA-GL-CS/G, and CTAB-CS/G adsorbents displayed maximum adsorption capacity values of 1.15, 4.31, 4.55, 6.90, and 9.03 mg g⁻¹, respectively. The adsorption results were well described by employing the pseudo-second-order kinetic and Langmuir isotherm models. The estimated thermodynamic constants indicated that the F⁻ ion adsorption was a spontaneous, physisorption process. Furthermore, the modified chitosan adsorbents are good candidates for the adsorptive elimination of F⁻ ions from aqueous solutions, according to their reusability, high stability, good adsorption capacity, and applicability for actual field water samples.

We herein have developed a mild approach for the fabrication of glauconite clay (G)-modified chitosan (CS) nanocomposites by the combination of a simple blending and crosslinking method.