12 research outputs found
Synchronized epiaortic two-dimensional and color Doppler echocardiographic guidance enable routine ascending aortic cannulation in type A acute aortic dissection
No full textA Potential Link Between Oxidative Stress and Endothelial-to-Mesenchymal Transition in Systemic Sclerosis
No full textThis article was submitted to
Immunological Tolerance and
Regulation,
a section of the journal
Frontiers in Immunology.
This is an open-access article distributed under the terms of the Creative Commons
Attribution License (CC BY). The use, distribution or reproduction in other forums
is permitted, provided the original author(s) and the copyright owner(s) are credited
and that the original publication in this journal is cited, in accordance with accepted
academic practice. No use, distribution or reproduction is permitted which does not
comply with these terms.Systemic sclerosis (SSc), an autoimmune disease that is associated with a number
of genetic and environmental risk factors, is characterized by progressive fibrosis and
microvasculature damage in the skin, lungs, heart, digestive system, kidneys, muscles,
joints, and nervous system. These abnormalities are associated with altered secretion of
growth factor and profibrotic cytokines, such as transforming growth factor-beta (TGF-b),
interleukin-4 (IL-4), platelet-derived growth factor (PDGF), and connective-tissue growth
factor (CTGF). Among the cellular responses to this proinflammatory environment, the
endothelial cells phenotypic conversion into activated myofibroblasts, a process known
as endothelial tomesenchymal transition (EndMT), has been postulated. Reactive oxygen
species (ROS) might play a key role in SSs-associated fibrosis and vascular damage
by mediating and/or activating TGF-b-induced EndMT, a phenomenon that has been
observed in other disease models. In this review, we identified and critically appraised
published studies investigating associations ROS and EndMT and the presence of
EndMT in SSc, highlighting a potential link between oxidative stress and EndMT in this
condition.This research was
supported by grants from the Qatar National Research Fund
(UREP20-051-3-012) and the Qatar University (QUCG-CHS-
2018/2019-1). The article processing charge (APC) for the
publication of this article was funded by the (Qatar National
Library)
Early outcomes of transection of secondary chordae with downsized ring annuloplasty in low recurrence risk severe ischemic mitral regurgitation
No full textBackground: Relying solely on restrictive annuloplasty for the repair of ischemic mitral regurgitation is associated with an unacceptable rate of recurrence. Transection of secondary chordae as an adjunctive procedure has been proposed to improve results.Patient and methods: This is a prospective observational study including 20 patients who underwent mitral repair using downsized annuloplasty ring and transection of the secondary chordae, at the time of CABG at the Cardiothoracic Surgery Department of Cairo University Hospitals through the period between March 2016 and October 2018. The primary outcome being examined was the recurrence of significant mitral regurgitation at 6 months postoperatively. Secondary outcomes included coaptation length and ejection fraction.Results: The mean age was 57.5 ± 6.9 years. The mean ejection fraction was 45.1 ± 11%. There was one early mortality (5%). At 6 months postoperatively, there was no incidence of recurrence of significant mitral regurgitation. Coaptation length was quite satisfactory (7.2 ± 0.67 mm).Conclusion: Transection of secondary chordae is a safe and simple option. It may be beneficial when performed in combination with downsized ring annuloplasty in patients with low-risk ischemic mitral regurgitation
Mitral valve annuloplasty with a homemade single-sized polytetrafluoroethylene band in degenerative mitral regurgitation
No full textBackground: Although mitral annuloplasty is an essential component of mitral repair, there remains little agreement on the ideal device to be used or the ideal sizing method.Objectives: The purpose of this study was to report the early clinical and echocardiographic outcomes of patients undergoing repair for degenerative mitral regurgitation using a homemade single-sized (65 mm) Polytetrafluoroethylene band, and comparing it to the use of commercially available complete rigid rings.Patients and methods: This is a retrospective study including 106 patients, who underwent mitral repair for degenerative mitral regurgitation at Cairo University Hospitals between February 2013 and July 2019. These patients were divided into 2 groups. Group (A) included 69 patients who underwent repair with a single-sized band, and group (B) included 37 patients whose repair included the use of a commercial rigid ring. The primary endpoint was freedom from significant mitral regurgitation at one-year follow-up. Secondary endpoints included mean mitral valve gradient measured postoperatively, and freedom from reoperation at one year.Results: There was no statistically significant difference between both groups in any of the above-mentioned endpoints being examined.Conclusion: The use of a single-sized Polytetrafluoroethylene band for annuloplasty in degenerative mitral disease showed satisfactory results comparable to the commercial rigid rings. Further studies with longer follow-up are needed to confirm the durability of mitral repair using this technique
Tricuspid valve repair by DeVega technique versus ring annuloplasty in patients with functional severe tricuspid regurge
No full textAbstractBackgroundRepairing the tricuspid valve in patients undergoing left heart valve surgery is still controversial. Severe Tricuspid regurge is repaired by most surgeons, while moderate regurge is frequently unaddressed. Another controversy is the technique of repair. DeVega technique is widely used; still, the longevity of this repair is still questioned. The risk of its early failure and subsequent recurrence of significant regurge requiring redo surgery has led many surgeons to adopt the use of annuloplasty rings. The aim of our study was to assess the short term results (1 year) of tricuspid repair with or without ring annuloplasty.Patients and methods80 patients who had tricuspid repair concomitantly with mitral valve surgery at Cairo University Hospitals over 5 years were studied by echocardiography at discharge and at 1 year after surgery.Results62 patients had repair using the DeVega annuloplasty (group A) while 18 had ring annuloplasty (group B). The mean age was 33 ± 6 years and 37 ± 8 years for group A and B respectively. The cardiopulmonary bypass (CPB) time was relatively longer in group B. There was only one mortality in group A. Echocardiography done for all patients of both groups at discharge and at 1 year postoperatively showed no significant difference between both groups.ConclusionTricuspid repair using ring annuloplasty has good results but with no significant benefits over DeVega annuloplasty at one year
Cannulating a Dissecting Aorta Using Ultrasound-Epiaortic and Transesophageal Guidance
No full text<p>Management of acute Stanford type A aortic dissection remains a major surgical challenge. Directly cannulating the ascending aorta provides a rapid establishment of cardiopulmonary bypass but consists of risks such as complete rupture of the aorta, false lumen cannulation, subsequent malperfusion and propagation of the dissection.</p><p>We describe a technique of cannulating the ascending aorta in patients with acute aortic dissection that can be performed rapidly in hemodynamically unstable patients under ultrasound-epiaortic and transesophageal (TEE) guidance.</p></jats:p
The value of intra-operative epiaortic scanning in patients submitted for coronary artery bypass grafting
No full textThe aim of the work to assess the value of epiaortic ultrasound prevention of stroke and other postoperative complications, and whether its use leads to changes of planned intra-operative surgical management in patients undergoing CABG surgery compared its performance to TEE. 100 patients who underwent primary isolated CABG from may 2016 into may 2017 as it represent 40% of total primary isolated CABG was done in this time. Patients were prospectively randomized into Two groups. These study was performed in KOBRY EL KOBA Military Hospital. Patients were divided into Epiaortic group "Group A" and TEE & palpation group "Group B ". The primary endpoint of this study was an incidence of early post-operative stroke. The secondary endpoint of this study was an incidence of early post-operative MI, AF, renal failure, deep wound infection
Monetizing Personal Data: A Two-Sided Market Approach
No full textAbstractMobile phone-based sensing is a new paradigm that aims at using smartpohnes to answer sensing requests and collect useful data. Nowadays, a wide variety of domains ranging from health-care applications to pollution monitoring are benefiting from such collected data. However, despite its increasing popularity and the huge amount of data provided by users, there is no platform where mobile phone owners can effectively sell their data. In this paper, we propose the idea of a data monetization platform using two-sided market theory. In this platform, the data is viewed as an economic good and the data sharing activity is considered as an economic transaction. The proposed platform considers the case of abundant data. An experimental analysis is conducted to compare our approach against the peer-to-peer model using a real case study from the health care domain. We show that our proposed platform has the potential to generate higher profit for both data providers and data consumers
The Arab Gulf countries and the Arab- Israeli conflict;: the linkages and dynamics (1970-2000)
No full textThis thesis examines the changing linkages and dynamics of the relationship between the Arab Gulf countries and the Arab-Israeli conflict through the period of 1970-2000. The Arab Gulf countries' level of involvement in supporting the Arabs and Palestinians in the Arab-Israeli conflict diminished throughout the period of study. The thesis explains this diminishing role by discussing the impact of the developments of international struggle for influence in the Gulf as well as the Israeli ambitions and relations to the Gulf region, largely expressed through the Israeli relationship with Iran under the Shah. The thesis shows that the years 1973, 1979 and 1990 formed important turning points for international influence in the region. These turning points influenced on the level of the Arab Gulf countries' involvement in the Arab-Israeli conflict. Throughout the seventies, the Arab Gulf countries played an active role in supporting the Arab side in the Arab-Israeli conflict. The clearest expression of this support was the implementation of the oil embargo against the West during the October 1973 War. The eighties witnessed the birth of the Gulf Cooperation Council (GCC), the formation of which symbolized the emerging security challenges within the Gulf region. These security challenges represented by the Iranian Revolution, the Iran-Iraq war and the Soviet invasion and occupation of Afghanistan exhausted most of the capabilities and efforts of the Arab Gulf countries. Their focus and attention shifted away from the Arab-Israeli conflict, in spite of the serious and dramatic developments in that conflict. The repercussions of the Iraqi invasion of Kuwait in 1990 resulted in a further diminishment of the role of the Arab Gulf countries in backing the Palestinians in the Arab-Israeli conflict. Only after September 2000 and the beginning of the Second Palestinian Intifada did the Arab Gulf countries again play a vital role, by means of financial, political and media support. The thesis explains the linkages between security in the Gulf and the Arab- Israeli conflict. It examines the hypothesis that a reciprocal relationship explaining the level and type of Arab Gulf countries involvement in the Arab-Israeli conflict has existed throughout the period of the study
Pancreatic surgery outcomes: multicentre prospective snapshot study in 67 countries
No full textBackground: Pancreatic surgery remains associated with high morbidity rates. Although postoperative mortality appears to have
improved with specialization, the outcomes reported in the literature reflect the activity of highly specialized centres. The aim of
this study was to evaluate the outcomes following pancreatic surgery worldwide.
Methods: This was an international, prospective, multicentre, cross-sectional snapshot study of consecutive patients undergoing
pancreatic operations worldwide in a 3-month interval in 2021. The primary outcome was postoperative mortality within 90 days of
surgery. Multivariable logistic regression was used to explore relationships with Human Development Index (HDI) and other parameters.
Results: A total of 4223 patients from 67 countries were analysed. A complication of any severity was detected in 68.7 per cent of
patients (2901 of 4223). Major complication rates (Clavien–Dindo grade at least IIIa) were 24, 18, and 27 per cent, and mortality rates
were 10, 5, and 5 per cent in low-to-middle-, high-, and very high-HDI countries respectively. The 90-day postoperative mortality
rate was 5.4 per cent (229 of 4223) overall, but was significantly higher in the low-to-middle-HDI group (adjusted OR 2.88, 95 per
cent c.i. 1.80 to 4.48). The overall failure-to-rescue rate was 21 per cent; however, it was 41 per cent in low-to-middle- compared
with 19 per cent in very high-HDI countries.
Conclusion: Excess mortality in low-to-middle-HDI countries could be attributable to failure to rescue of patients from severe
complications. The authors call for a collaborative response from international and regional associations of pancreatic surgeons to
address management related to death from postoperative complications to tackle the global disparities in the outcomes of pancreatic
surgery (NCT04652271; ISRCTN95140761)
