1.Mechanical Thrombectomy for Acute Ischemic Stroke in Metastatic Cancer Patients: A Nationwide Cross-Sectional Analysis
Hassan ABOUL-NOUR ; Ahmed MARAEY ; Ammar JUMAH ; Mahmoud KHALIL ; Ahmed M. ELZANATY ; Hadeer ELSHARNOBY ; Fawaz AL-MUFTI ; Alex Bou CHEBL ; Daniel J. MILLER ; Stephan A. MAYER
Journal of Stroke 2023;25(1):119-125
Background:
and Purpose Mechanical thrombectomy (MT) is the standard treatment for large vessel occlusion (LVO) acute ischemic stroke. Patients with active malignancy have an increased risk of stroke but were excluded from MT trials.
Methods:
We searched the National Readmission Database for LVO patients treated with MT between 2016–2018 and compared the characteristics and outcomes of cancer-free patients to those with metastatic cancer (MC). Primary outcomes were all-cause in-hospital mortality and favorable outcome, defined as a routine discharge to home (regardless of whether home services were provided or not). Multivariate regression was used to adjust for confounders.
Results:
Of 40,537 LVO patients treated with MT, 933 (2.3%) had MC diagnosis. Compared to cancer-free patients, MC patients were similar in age and stroke severity but had greater overall disease severity. Hospital complications that occurred more frequently in MC included pneumonia, sepsis, acute coronary syndrome, deep vein thrombosis, and pulmonary embolism (P<0.001). Patients with MC had similar rates of intracerebral hemorrhage (20% vs. 21%) but were less likely to receive tissue plasminogen activator (13% vs. 23%, P<0.001). In unadjusted analysis, MC patients as compared to cancer-free patients had a higher in-hospital mortality rate and were less likely to be discharged to home (36% vs. 42%, P=0.014). On multivariate regression adjusting for confounders, mortality was the only outcome that was significantly higher in the MC group than in the cancerfree group (P<0.001).
Conclusion
LVO patients with MC have higher mortality and more infectious and thrombotic complications than cancer-free patients. MT nonetheless can result in survival with good outcome in slightly over one-third of patients.
2.Assessment of Behavioral Problems in Children Pre- and Post-Cochlear Implant: An Egyptian Study
Ahmed Ali ABDELMONEM ; Hisham SALAH ; Heba Ashour MOSTAFA ; Noha A. Abd ELMONEM ; Doaa Mahmoud KHALIL ; Rabie Sayed YOUSSEF ; Reham Ahmed FAHIEM
Psychiatry Investigation 2022;19(9):763-769
Objective:
The present study aimed to detect the behavioral problems pre- and post-cochlear implantation in comparison to normal hearing group to be able to manage these problems to get more benefit from using cochlear implants.
Methods:
A case-control study included 53 children was done. They were divided into 2 groups, the control group included 28 healthy volunteers with normal hearing and the case group included 25 children with severe to profound hearing loss, fitted for cochlear implantation. The Arabic Child Behavior Checklist (CBCL) was used to detect different behavioral problems in both groups. Case group children were followed up and reassessed again by CBCL 3 months later after cochlear implantation.
Results:
There were highly significant differences regarding total scores of internalizing and externalizing domains of empirically based CBCL between the control group and the case group after cochlear implants (p=0.001). There were non-significant differences in children within case group (pre- and post-cochlear implantation) regarding emotional and behavioral problems on both empirically based and Diagnostic and Statistical Manual of Mental Disorders-based CBCL.
Conclusion
For better results, it is necessary to include a specialist of psychosomatic medicine in the cochlear rehabilitation teamwork.
3.Adverse health events experienced by the recipients of COVID-19 vaccines and the associated factors in southwestern Saudi Arabia
Ashraf Ewis ; Omer Abdelbagi ; Marwa Abdelrahim ; Eman Ghazawy ; Shaza Fadel ; Doaa Mahmoud Khalil ; Omar AlHazazi ; Mosad Odah ; Mohamed Elhefny
Malaysian Journal of Microbiology 2023;19(no.2):166-174
Aims:
Studying the post-vaccination adverse health events is crucial to determine the confidence and acceptance of the public to the newly-developed COVID-19 vaccines. The present study aimed to investigate the prevalence rates of the adverse health events experienced by the recipients of COVID-19 vaccines in Saudi Arabia.
Methodology and results:
A cross-sectional study was conducted in October 2021 using a google form of an online self-administered questionnaire sent via different social media platforms for recruiting participants from southwestern Saudi Arabia. The questionnaire was prepared by medical and public health professionals and then translated into Arabic, pilot-studied and validated. Among the 453 Saudi adults who participated in the study with at least one dose of the COVID-19 vaccine, about (77.9%) were males aged 25.5 ± 10.6 years. Most of the participants were college students living in the Makkah region. Nearly 68.3% reported post-vaccination adverse events, such as injection site pain/swelling (91.9%), fatigue (67.9%), bone and muscle pain (65.2%) and flu-like symptoms (58%). The type of vaccine was significantly associated with the development of adverse events p=0.002 (OR of Pfizer-BioNTech versus AstraZeneca: 0.33, 95% CI: 0.18-0.61). Additionally, ageing of more than the 3rd decade, male gender and being married were significantly associated with lower rates of reporting post-vaccination adverse events.
Conclusion, significance and impact of study
The development of COVID-19 vaccine-related adverse health events had no significant associations with residence, education, occupation, BMI, chronic diseases or smoking. However, age, gender, marital state and vaccine type may be considered significant predictors for developing post-vaccination adverse
reactions.