Objectives Risk of cardiovascular events in ST-segment–elevation myocardial infarction survivors remains substantial despite advances in management of STEMI. Efforts have been directed to identify factors endangering those survivors, admission hyperglycemia (AH) is a considerable one. We aimed to determine effect of AH on area at risk (AAR), final infarct size (FIS) and myocardial salvage in STEMI patients using cardiac magnetic resonance (CMR). Methods We recruited 43 successfully reperfused STEMI patients. AH was defined as a glucose level ≥ 140 mg/dl in non-diabetics while a cut-off value 250 mg/dl for diabetics. We assigned the recruit into AH group (n=21) and euglycemic group (n=22). T2-weighted sequences short-tau inversion-recovery turbo-spin echo sequence (STIR) was utilized to estimate AAR, segmented inversion recovery steady-state free precession sequence (PSIR) was used to estimate IS, then salvage index (SI) was calculated: SI = AAR- FIS/ AAR. Results AH showed significant positive correlations to FIS (r value = 0.538, P = 0.001), and AAR (r value = 0.435, P=0.002), and a significant negative correlation with SI (r value = -0.378, P=0.006). Moreover, AH group had higher CMR estimated WMSI (1.56 ± 0.2 -1.39 ± 0.3 respectively, p =0.021) and lower segmental 65-40-15 ejection fraction (EF) score (49.36 ± 7.1 - 55.26 ± 6.1 respectively, p = 0.006). Multivariate analysis showed that AH was independent predictor of SI. Conclusion Current study showed an adverse effect of AH on SI in STEMI patients. So, we recommend strict glycemic control.

Objectives Risk of cardiovascular events in ST-segment–elevation myocardial infarction survivors remains substantial despite advances in management of STEMI. Efforts have been directed to identify factors endangering those survivors, admission hyperglycemia (AH) is a considerable one. We aimed to determine effect of AH on area at risk (AAR), final infarct size (FIS) and myocardial salvage in STEMI patients using cardiac magnetic resonance (CMR). Methods We recruited 43 successfully reperfused STEMI patients. AH was defined as a glucose level ≥ 140 mg/dl in non-diabetics while a cut-off value 250 mg/dl for diabetics. We assigned the recruit into AH group (n=21) and euglycemic group (n=22). T2-weighted sequences short-tau inversion-recovery turbo-spin echo sequence (STIR) was utilized to estimate AAR, segmented inversion recovery steady-state free precession sequence (PSIR) was used to estimate IS, then salvage index (SI) was calculated: SI = AAR- FIS/ AAR. Results AH showed significant positive correlations to FIS (r value = 0.538, P = 0.001), and AAR (r value = 0.435, P=0.002), and a significant negative correlation with SI (r value = -0.378, P=0.006). Moreover, AH group had higher CMR estimated WMSI (1.56 ± 0.2 -1.39 ± 0.3 respectively, p =0.021) and lower segmental 65-40-15 ejection fraction (EF) score (49.36 ± 7.1 - 55.26 ± 6.1 respectively, p = 0.006). Multivariate analysis showed that AH was independent predictor of SI. Conclusion Current study showed an adverse effect of AH on SI in STEMI patients. So, we recommend strict glycemic control.

Simple Summary:Sarcoptic mange is an important zoonotic parasite affecting camel production.Mange zoonosis in camels is complicated by scarcity of available data. One of the main strategies fordisease control is early detection of the parasite combined with prevention/control of the major riskfactors associated with the infection. The present study focused on the prevalence of sarcoptic mangein camels from Egypt together with a histopathological examination of the parasite and association ofthe major risk factors, to describe the epidemiological pattern of the disease. Our data demonstratethat 47.6% of the camels harbored sarcoptic mange infections. In addition, the animals exhibitedobvious clinical signs of mange and numerous histopathological findings that are consistent withsarcoptic mange. The camel’s age, gender and sampling season were found to be the most significantrisk factors associated with the disease. Taken together, our epidemiological and histopathologicaldata are consistent with sarcoptic mange being widespread among camels in the studied area.Our study suggests further research is needed for management of this zoonotic disease in Egypt.Abstract:Mange has been considered one of the most common parasitic infestations among camels.It adversely impacts animal productivity and poses a risk to human health. Given the scarcity ofavailable data about mange in camels, the current study focused on the prevalence of camel mange andits associated risk factors in Aswan Governorate, Egypt. Towards this end, a general visual inspectionwas conducted on camels (N=210) in different markets and slaughterhouses in Aswan Governorate (PDF) Epidemiological and Histopathological Investigation of Sarcoptic Mange in Camels in Egypt. Available from: https://www.researchgate.net/publication/343844625_Epidemiological_and_Histopathological_Investigation_of_Sarcoptic_Mange_in_Camels_in_Egypt [accessed Sep 02 2020].Skin scrapings from suspect infected camels were also examined microscopically. Importantly,these findings were further checked and confirmed by histopathology on samples from suspectedcases collected post-slaughter in abattoirs. The possible risk-associated factors, which include thecamel’s age, sex and sampling season, were recorded and statistically analyzed. Interestingly, thedata showed that a total of 100 camels (47.6%) were found exclusively infested by sarcoptic mange.Furthermore, the predominant histopathological changes included burrowing tunnel of mites in theskin, hyperkeratosis and acanthosisconsis of the epidermis, while the dermis showed hemorrhage,mononuclear inflammatory cell infiltration around the blood vessels and perifolliculitis. These majorhistopathological findings are consistent with sarcoptic mange. Furthermore, the statistical analysisof the possible associated risk factors, camel’s age (p=0.006), gender (p=0.032) and sampling season(p=0.004), were all found to be significantly affected and related to the disease. In this regard, camels≥2 years old were found at higher risk of infection (odds ratio (OR)=2.75; 95% confidence interval(CI), 1.345 to 5.604) versus younger animals (OR=0.36; 95 CI, 0.1784 to 0.743). Females had higherodds of exposure (OR=2.02; 95% CI, 1.096 to 3.708) compared to males (OR=0.50; 95% CI, 0.269to 0.912). Moreover, the exposure to infection was reported higher in winter (OR=2.30; 95% CI,1.297 to 4.098) than in summer (OR=0.43; 95% CI, 0.244 to 0.771). Collectively, our data providenovel epidemiological and histopathological support for sarcoptic mange being widespread amongcamels in the studied area. Sarcoptic mange is extremely contagious and zoonotic. Therefore, ourbaseline investigation indicates an urgent need for additional multicenter-studies to investigate theoccurrence of this disease in camels and humans combined with the appropriate control measures ofcamel importation for combating this disease. (PDF) Epidemiological and Histopathological Investigation of Sarcoptic Mange in Camels in Egypt. Available from: https://www.researchgate.net/publication/343844625_Epidemiological_and_Histopathological_Investigation_of_Sarcoptic_Mange_in_Camels_in_Egypt [accessed Sep 02 2020].

Our purpose was to evaluate and to compare the screening efficacy of the fetal middle cerebral artery (MCA) and umbilical artery (UA) Doppler ultrasonography for diagnosis and prediction of adverse perinatal outcome in suspected cases of intrauterine growth restriction (IUGR). Study design: The umbilical artery and fetal middle cerebral artery indices were measured in 30 fetuses suspected to have IUGR (28-36 weeks at recruitment and US-estimated weight or abdominal circumference below 10th percentile). Results: In this study, 9 cases (30%) had at least one adverse perinatal outcome. These adverse outcomes included; stillbirth, neonatal death, intubation, hypoglycemia, necrotizing enterocolitis, 5-minutes Apgar score >7, cesarean delivery for fetal distress and intensive care unit stay for more than 24 hours. The MCA indices were more sensitive but less specific in detecting the adverse perinatal outcome than the UA indices. Conclusion: Our data suggest that for management of suspected cases of IUGR, abnormal UA indices is a better predictor of perinatal morbidity and mortality than abnormal MCA indices. However, normal MCA indices may help to identify fetuses without adverse perinatal outcome.

Our purpose was to evaluate and to compare the screening efficacy of the fetal middle cerebral artery (MCA) and umbilical artery (UA) Doppler ultrasonography for diagnosis and prediction of adverse perinatal outcome in suspected cases of intrauterine growth restriction (IUGR). Study design: The umbilical artery and fetal middle cerebral artery indices were measured in 30 fetuses suspected to have IUGR (28-36 weeks at recruitment and US-estimated weight or abdominal circumference below 10th percentile). Results: In this study, 9 cases (30%) had at least one adverse perinatal outcome. These adverse outcomes included; stillbirth, neonatal death, intubation, hypoglycemia, necrotizing enterocolitis, 5-minutes Apgar score >7, cesarean delivery for fetal distress and intensive care unit stay for more than 24 hours. The MCA indices were more sensitive but less specific in detecting the adverse perinatal outcome than the UA indices. Conclusion: Our data suggest that for management of suspected cases of IUGR, abnormal UA indices is a better predictor of perinatal morbidity and mortality than abnormal MCA indices. However, normal MCA indices may help to identify fetuses without adverse perinatal outcome.

Our purpose was to evaluate and to compare the screening efficacy of the fetal middle cerebral artery (MCA) and umbilical artery (UA) Doppler ultrasonography for diagnosis and prediction of adverse perinatal outcome in suspected cases of intrauterine growth restriction (IUGR). Study design: The umbilical artery and fetal middle cerebral artery indices were measured in 30 fetuses suspected to have IUGR (28-36 weeks at recruitment and US-estimated weight or abdominal circumference below 10th percentile). Results: In this study, 9 cases (30%) had at least one adverse perinatal outcome. These adverse outcomes included; stillbirth, neonatal death, intubation, hypoglycemia, necrotizing enterocolitis, 5-minutes Apgar score >7, cesarean delivery for fetal distress and intensive care unit stay for more than 24 hours. The MCA indices were more sensitive but less specific in detecting the adverse perinatal outcome than the UA indices. Conclusion: Our data suggest that for management of suspected cases of IUGR, abnormal UA indices is a better predictor of perinatal morbidity and mortality than abnormal MCA indices. However, normal MCA indices may help to identify fetuses without adverse perinatal outcome.

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