Automated total kidney volume measurements in pre-clinical magnetic resonance imaging for resourcing imaging data,annotations, and source code

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Acceptance of a COVID-19 Vaccine and Its Related Determinants among the General Adult Population in Kuwait

ObjectiveThe objective of this study was to determine the acceptance of a coronavirus disease 2019 (COVID-19) vaccine among the general adult population in Kuwait and assess its determinants.Subjects and MethodsA web-based cross-sectional study was conducted by enrolling adults living in Kuwait (n = 2,368; aged ≥21 years). Acceptance of a COVID-19 vaccine was inferred if participants indicated that they “definitely or probably will accept vaccination against COVID-19 once a vaccine is available.” Associations were explored by applying a modified Poisson regression to estimate and infer adjusted prevalence ratios (aPR) and their 95% confidence intervals (CI).ResultsIn total, 53.1% (1,257/2,368) of the participants were willing to accept a COVID-19 vaccine once available. Male subjects were more willing to accept a COVID-19 vaccine than females (58.3 vs. 50.9%, p < 0.001). Subjects who viewed vaccines in general to have health-related risks were less willing to accept vaccination (aPR = 0.39, 95% CI: 0.35–0.44). Moreover, participants who previously received an influenza vaccine were more likely to accept a COVID-19 vaccine (aPR = 1.44, 95% CI: 1.31–1.58). Willingness to get vaccinated against COVID-19 increased as the self-perceived chances of contracting the infection increased (p < 0.001).ConclusionOverall, 53.1% of the study participants demonstrated willingness to get vaccinated against COVID-19. We found several factors influencing the level of acceptance. Since vaccination appears to be an essential preventive measure that can halt the COVID-19 pandemic, factors relating to low vaccine acceptance need to be urgently addressed by public health strategies.     

Distinguishing diabetic nephropathy from other causes of glomerulosclerosis: an update

Diabetic nephropathy is a common cause of end-stage renal disease worldwide. It is characterised by diffuse or nodular glomerulosclerosis, afferent and efferent hyaline arteriolosclerosis, and tubulointerstitial fibrosis and atrophy. Diffuse and nodular diabetic glomerulosclerosis share similar histological features with other clinical conditions. Immunofluorescence and electron microscopy studies, and clinicopathological correlation are essential to differentiate diabetic nephropathy from other conditions that result in diffuse and nodular glomerulosclerosis.     

Hybrid approach to postmyocardial infarction ventricular septal defect repair

Postinfarction ventricular septal rupture is a rare and devastating complication of myocardial infarction. Despite attempts at acute surgical and percutaneous defect closure, morbidity and mortality remain high. Herein, we describe a hybrid surgical and catheter-based approach to defect closure in a 63-year-old woman with postinfarction ventricular septal rupture and cardiogenic shock.     

Salvaging of severely ruptured living-related renal allograft secondary to acute antibody mediated rejection

INTRODUCTION

Spontaneous renal allograft rupture (RAR) is a serious and potentially life-threatening complication of kidney transplantation. Debate on the management of RAR has focused on graft nephrectomy versus salvaging in cases where: the allograft rupture site is surgically manageable; the bleeding can be controlled; and/or leaving the renal allograft in situ does not compromise patient survival.

PRESENTATION OF CASE

A 45-year-old, living-related, female, kidney allograft recipient experienced RAR on the fourth day post transplantation. Surgical exploration showed 12 cm laceration along the convex border of the graft. Histologically the graft demonstrated mild acute kidney injury and linear deposition of C4d along the cortical peritubular capillaries; morphological features for violent humoral or cellular rejection were not identified. The graft was surgically salvaged with excellent clinical and biochemical improvement.

DISCUSSION

Observations arising from this case are: (1) RAR caused by rejection is still encountered in clinical practice despite effective immunosuppressive management; (2) the severity of the histopathological features of rejection does not necessarily correlate with the extent of graft rupture; and (3) salvaging the graft should be attempted whenever possible as current immunosuppression and advances in surgical techniques may have an impact on long-term graft function and survival, differing from those previously published.

CONCLUSION

With modern immunosuppression therapy and proven surgical procedures, the efficacy of salvaged renal grafts and graft survival rates may improve substantially.     

Defining Laterality of the Descending Thoracic Aorta in a 4‐Chamber View of the Heart

Objective. Right descending aortas have been correlated with an increased risk of congenital heart disease. Nevertheless, the aortic position remains a largely overlooked diagnostic tool in second‐trimester sonography because no formal system for assessing the position exists. By developing a method of assigning the position of the aorta relative to the thoracic midline, diagnostic use of the descending aorta's position might be implemented more easily. Methods. The method of assessing the position relative to the midline was tested by comparing the analysis of 2 independent observers, who showed a 94.4% concordance rate. Results. Comparison of the percentages of aortic positions between the gestational ages (GAs) of 18 and 21 weeks showed no significant correlation between the aortic position and GA. Conclusions. We suggest simply paying attention to the aortic position in an already standard view. The extra effort is minimal, and it has the potential to improve the diagnostic accuracy of the 4‐chamber view.     

My approach to superficial inflammatory dermatoses

Superficial inflammatory dermatoses are very common and comprise a wide, complex variety of clinical conditions. Accurate histological diagnosis, although it can sometimes be difficult to establish, is essential for clinical management. Knowledge of the microanatomy of the skin is important to recognise the variable histological patterns of inflammatory skin diseases. This article reviews the non-vesiculobullous/pustular inflammatory superficial dermatoses based on the compartmental microanatomy of the skin.     

Combined cilioretinal artery and hemi-retinal vein occlusion in Sturge Weber syndrome: Expanding the clinical spectrum

A 9-year-old boy with the diagnosis of Sturge-Weber Syndrome, and port-wine stain involving the right side of the face, presented with acute visual loss of the right eye. Examination revealed a high intraocular pressure and a combined cilioretinal artery and inferior hemi-retinal vein occlusion in the right eye. Systemic work-up was negative. After controlling the intraocular pressure, gradual improvement of vision was noticed with simultaneous disappearance of signs of vascular occlusion.