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Does local vaginal estrogen after tension-free transobturator vaginal tape reduce overactive bladder symptoms in postmenopausal women? A prospective randomized, controlled study

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Asian Journal of Urology 2024年第1期11卷 86-92页

作者： samer Mahmoud Morsy Dalia Farouk Sara Hassan Ahmed Yehia abdelaziz Hussein Aly Hussein Urology Department Kasr Al Ainy HospitalCairo UniversityCairoEgypt Obstetrics and Gynecology Department Kasr Al Ainy HospitalCairo UniversityCairoEgypt

Objective:We aimed to evaluate the efficacy of topical estrogen after transvaginal tension-free vaginal tape-obturator(TVT-O)in the treatment of de novo overactive bladder symptoms that appear after surgery.Methods:This is a prospective randomized controlled study performed in the Urology and Gynecology Departments,Kasr Al Ainy Hospital,Cairo University,Cairo,Egypt.Two hundred and ten postmenopausal females presenting during the period between January 2017 and November 2020 with stress urinary incontinence were included in the study.Patients were divided into two groups,105 patients in Group A(treatment group)and 105 patients in Group B(control group).Patients in Group A underwent transvaginal TVT-O followed by local vaginal estrogen treatment for 6 months,while patients in Group B underwent transvaginal TVT-O only.The study included any postmenopausal female with urodynamic stress urinary incontinence.All patients had to fulfill a 3-day bladder diary,overactive bladder symptoms score,urine analysis,urodynamic study,and post-voiding residual urine measurement by abdominal ultrasound preoperatively and at 3-month and 6-month follow-ups.Results:At 6-month follow-up,daytime frequency was reduced to 8%in Group A(increased to 21%in Group B)with a statistically significant difference between both groups(p=0.009).At 6-month follow-up,nocturia was 8%in Group A(11%in Group B)with no statistically significant difference between both groups(p=0.469).There was a statistically significant difference between both groups as regards to urinary urgency at 6-month follow-up(p=0.024).There was a statistically significant difference in postoperative wound healing events as regards to cure,hyperemia,gapping,and wound infection 1 week after intervention between both groups(p=0.008).No local or systemic side-effects were reported from local estrogen use.Conclusion:Local vaginal estrogen treatment given to postmenopausal patients after midurethral sling procedures can reduce the symptoms of daytime frequency and urinary urgency.Long-ter

关键词： Stressurinary incontinence Estrogen Midurethral sling Overactive bladder symptom

A gated recurrent unit model to predict Poisson’s ratio using deep learning

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Journal of Rock Mechanics and Geotechnical Engineering 2024年第1期16卷 123-135页

作者： Fahd Saeed Alakbari Mysara Eissa Mohyaldinn Mohammed Abdalla Ayoub Ibnelwaleed A.Hussein Ali samer Muhsan Syahrir Ridha Abdullah Abduljabbar Salih Petroleum Engineering Department Universiti Teknologi PETRONAS32610Bandar Seri IskandarPerakMalaysia Institute of Hydrocarbon Recovery Universiti Teknologi PETRONAS32610Bandar Seri IskandarPerakMalaysia Gas Processing Center College of EngineeringQatar UniversityP.O.Box 2713DohaQatar Department of Chemical Engineering College of EngineeringQatar UniversityP.O.Box 2713DohaQatar Mechanical Engineering Department Universiti Teknologi PETRONAS32610Bandar Seri IskandarPerakMalaysia

Static Poisson’s ratio(vs)is crucial for determining geomechanical properties in petroleum applications,namely sand production.Some models have been used to predict vs;however,the published models were limited to specific data ranges with an average absolute percentage relative error(AAPRE)of more than 10%.The published gated recurrent unit(GRU)models do not consider trend analysis to show physical behaviors.In this study,we aim to develop a GRU model using trend analysis and three inputs for predicting n s based on a broad range of data,n s(value of 0.1627-0.4492),bulk formation density(RHOB)(0.315-2.994 g/mL),compressional time(DTc)(44.43-186.9 μs/ft),and shear time(DTs)(72.9-341.2μ s/ft).The GRU model was evaluated using different approaches,including statistical error an-alyses.The GRU model showed the proper trends,and the model data ranges were wider than previous ones.The GRU model has the largest correlation coefficient(R)of 0.967 and the lowest AAPRE,average percent relative error(APRE),root mean square error(RMSE),and standard deviation(SD)of 3.228%,1.054%,4.389,and 0.013,respectively,compared to other models.The GRU model has a high accuracy for the different datasets:training,validation,testing,and the whole datasets with R and AAPRE values were 0.981 and 2.601%,0.966 and 3.274%,0.967 and 3.228%,and 0.977 and 2.861%,respectively.The group error analyses of all inputs show that the GRU model has less than 5% AAPRE for all input ranges,which is superior to other models that have different AAPRE values of more than 10% at various ranges of inputs.

关键词： Static Poisson’s ratio Deep learning Gated recurrent unit(GRU) Sand control Trend analysis Geomechanical properties

Continuous Inferior Alveolar Nerve Block Using an Indwelling Catheter and Inferior Maxillary Artery Embolization for the Management of Atypical Trigeminal Neuralgia

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Open Journal of Anesthesiology 2013年第9期3卷 375-378页

作者： samer abdel-aziz Ahmed Ghaleb Department of Anesthesiology and Pain Medicine University of Arkansas for Medical Sciences Little Rock USA

A 40-years-old female patient with severe right facial pain with a throbbing component along the mandibular division of the trigeminal nerve resistant to medical management. Continuous inferior alveolar nerve block with local anesthetics using an indwelling catheter provided a complete pain resolution for the patient for 2 weeks, after which the catheter got infected and was removed. A trial of balloon occlusion of the right internal maxillary artery provided complete resolution of the throbbing component of the patient’s pain. This was followed by permanent embolization with multiple coils.

关键词： Trigeminal Neuralgia Inferior Alveolar Nerve Block Inferior Maxilary Artery Embolization

Combined Sacral Nerve Roots Stimulation and Low Thoracic Spinal Cord Stimulation for the Treatment of Chronic Pelvic Pain

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Pain Studies and Treatment 2014年第2期2卷 86-90页

作者： samer abdel-aziz Ahmed Ghaleb Department of Anesthesiology and Pain Medicine University of Arkansas for Medical Sciences Little Rock USA

Some pelvic pain syndromes are very resistant to medical treatment. Several studies have demonstrated that sacral neuromodulation, which has been successfully used for the treatment of bladder dysfunction, incontinence, urinary retention and urinary frequency [1]-[3], can be successfully used for the treatment of chronic pelvic pain [4]-[7]. Several studies have also demonstrated significant involvement of dorsal column pathways in the transmission of visceral pelvic pain [8] and the successful use of spinal cord stimulation for the treatment of chronic pelvic pain [9]. We report three cases of severe chronic pelvic pain that failed conservative treatment modalities. Placement of a combined sacral nerve roots stimulator and a low thoracic spinal cord stimulator resulted in a significant pain relief and improvement in daily life activities. We believe that this combination may help patients suffering from chronic pelvic pain resistant to medical management.

关键词： Chronic Pelvic Pain Sacral Nerve Roots Stimulation Thoracic Spinal Cord Stimulation

Change in Impedance with Change in Posture during Spinal Cord Stimulator Placement

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Pain Studies and Treatment 2014年第2期2卷 70-72页

作者： samer abdel-aziz Ahmed Ghaleb Department of Anesthesiology and Pain Medicine University of Arkansas for Medical Sciences Little Rock USA

In this article we discuss the effect of posture on impedance during the placement of a spinal cord stimulator. Although, according to several studies, there appears not to be a specific and consistent change in impedance with change in posture, we noticed on multiple occasions that if the impedance remains very high during spinal cord stimulator (SCS) lead placement, asking the patient to sit up from the prone position may drop the impedance down. This could be explained by having air around the lead, from using loss of resistance to air technique in finding the epidural space, which moves up when sitting the patient up, or having the lead immersed in epidural fat. Sitting the patient up from the prone position should be tried if the impedance remains very high before aborting the procedure and taking the lead out.

关键词： Impedance Spinal Cord Stimulator Change in Posture

Mapping the global research landscape on nonalcoholic fatty liver disease and insulin resistance:A visualization and bibliometric study

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World Journal of Hepatology 2024年第6期16卷 951-965页

作者： Sa'ed H Zyoud Omar E Hegazi samer O Alalalmeh Muna Shakhshir Faris Abushamma Shadi Khilfeh Samah W Al-Jabi Department of Clinical and Community Pharmacy College of Medicine and Health SciencesAn-Najah National UniversityNablus 44839Palestine Clinical Research Center An-Najah National University HospitalNablus 44839Palestine College of Pharmacy and Health Sciences Ajman UniversityAjman 346United Arab Emirates Department of Nutrition An-Najah National University HospitalNablus 44839Palestine Department of Medicine College of Medicine and Health SciencesAn-Najah National UniversityNablus 44839Palestine Department of Urology An-Najah National University HospitalNablus 44839Palestine Department of Gastroenterology Hepatology and EndoscopyAn-Najah National University HospitalNablus 44839Palestine

BACKGROUND Nonalcoholic fatty liver disease(NAFLD)is a liver condition that is prevalent worldwide and associated with significant health risks and economic burdens.As it has been linked to insulin resistance(IR),this study aimed to perform a bibliometric analysis and visually represent the scientific literature on IR and NAFLD.AIM To map the research landscape to underscore critical areas of focus,influential studies,and future directions of NAFLD and IR.METHODS This study conducted a bibliometric analysis of the literature on IR and NAFLD indexed in the SciVerse Scopus database from 1999 to 2022.The search strategy used terms from the literature and medical subject headings,focusing on terms related to IR and NAFLD.VOSviewer software was used to visualize research trends,collaborations,and key thematic areas.The analysis examined publication type,annual research output,contributing countries and institutions,funding agencies,journal impact factors,citation patterns,and highly cited references.RESULTS This analysis identified 23124 documents on NAFLD,revealing a significant increase in the number of publications between 1999 and 2022.The search retrieved 715 papers on IR and NAFLD,including 573(80.14%)articles and 88(12.31%)reviews.The most productive countries were China(n=134;18.74%),the United States(n=122;17.06%),Italy(n=97;13.57%),and Japan(n=41;5.73%).The leading institutions included the Universitàdegli Studi di Torino,Italy(n=29;4.06%),and the Consiglio Nazionale delle Ricerche,Italy(n=19;2.66%).The top funding agencies were the National Institute of Diabetes and Digestive and Kidney Diseases in the United States(n=48;6.71%),and the National Natural Science Foundation of China(n=37;5.17%).The most active journals in this field were Hepatology(27 publications),the Journal of Hepatology(17 publications),and the Journal of Clinical Endocrinology and Metabolism(13 publications).The main research hotspots were“therapeutic approaches for IR and NAFLD”and“inflammatory and high-fat diet impacts on NAFLD”.CONCLUS

关键词： Nonalcoholic fatty liver disease Insulin resistance Bibliometric Visualization

Lean body mass index is a marker of advanced tumor features in patients with hepatocellular carcinoma

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World Journal of Hepatology 2024年第3期16卷 393-404页

作者： Andrew Scott deLemos Jing Zhao Milin Patel Banks Kooken Karan Mathur Hieu Minh Nguyen Areej Mazhar Maggie McCarter Heather Burney Carla Kettler Naga Chalasani samer Gawrieh Department of Medicine Atrium HealthCharlotteNC 28204United States Center for Outcomes Research and Evaluation Atrium HealthCharlotteNC 28204United States Department of Medicine Indiana University School of MedicineIndianapolisIN 46202United States Center for Health System Sciences(CHASSIS) Atrium HealthCharlotteNC 28204United States Department of Medicine Northwestern University Feinberg School of MedicineChicagoIL 60611United States Department of Biostatistics and Health Data Science Indiana University School of MedicineIndianapolisIN 46202United States Department of Gastroenterology and Hepatology Indiana University School of MedicineIndianapolisIN 46202United States

BACKGROUND Obesity is an independent risk factor for the development of hepatocellular carcinoma(HCC)and may influence its outcomes.However,after diagnosis of HCC,like other malignancies,the obesity paradox may exist where higher body mass index(BMI)may in fact confer a survival benefit.This is frequently observed in patients with advanced HCC and cirrhosis,who often present late with advanced tumor features and cancer related weight loss.AIM To explore the relationship between BMI and survival in patients with cirrhosis and HCC.METHODS This is a retrospective cohort study of over 2500 patients diagnosed with HCC between 2009-2019 at two United States academic medical centers.Patient and tumor characteristics were extracted manually from medical records of each institutions'cancer registries.Patients were stratified according to BMI classes:30 kg/m^(2)(obese).Patient and tumor characteristics were compared according to BMI classification.We performed an overall survival analysis using Kaplan Meier by the three BMI classes and after adjusting for Milan criteria.A multivariable Cox regression model was then used to assess known risk factors for survival in patients with cirrhosis and HCC.RESULTS A total of 2548 patients with HCC were included in the analysis of which 11.2%(n=286)were classified as noncirrhotic.The three main BMI categories:Lean(n=754),overweight(n=861),and obese(n=933)represented 29.6%,33.8%,and 36.6%of the total population overall.Within each BMI class,the non-cirrhotic patients accounted for 15%(n=100),12%(n=94),and 11%(n=92),respectively.Underweight patients with a BMI<18.5 kg/m^(2)(n=52)were included in the lean cohort.Of the obese cohort,42%(n=396)had a BMI≥35 kg/m^(2).Out of 2262 patients with cirrhosis and HCC,654(29%)were lean,767(34%)were overweight,and 841(37%)were obese.The three BMI classes did not differ by age,MELD,or Child-Pugh class.Chronic hepatitis C was the dominant etiology in lean compared to the overweight and obese patients(

关键词： Hepatocellular carcinoma Cirrhosis Obesity Body mass index class Sarcopenia Chronic hepatitis C

Anaphylactoid Shock with Infusion of 5% Albumin in a Patient under General Anesthesia

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Open Journal of Anesthesiology 2012年第5期2卷 214-216页

作者： samer abdel-aziz Esamelden abdelnaem Neeraj Kumar Mohamed Ismaeil Department of Anesthesiology University of Arkansas for Medical Sciences Little Rock USA

A 61 year old male patient undergoing gastrectomy under general anesthesia developed severe anaphylactoid shock after 15 minutes from starting 5% albumin infusion. His blood pressure went from 101/67 down to 44/23 with his heart rate going up from 91 to 99. A total of 1600 mcg of phenylephrine were given without any improvement in the hemo-dynamics. We then gave 50 mcg of Epinephrine to which blood pressure rapidly responded going up to 141/60 (mean 88). Then 15 mg of Dexamethasone were given. Blood pressure remained stable with the mean between 75 and 90, without requiring anymore pressors. 5% albumin is considered among the safer colloids with a risk of anaphylactoid reactions less than gelatins and dextrans and comparable to starches. However, severe life threatening anaphylaxis has been reported with Albumin infusion. With the still ongoing crystalloid colloid debate, with many studies showing no survival benefit with colloid use for volume resuscitation, the risk of severe anaphylactic shock, even with the safer colloids like albumin should drive to a more conservative use of albumin for volume resuscitation, specially under general anesthesia, when recognizing the signs and symptoms of anaphylaxis and the offending agent maybe more challenging.

关键词： Albumin Colloids Anaphylaxis Anesthesia

Outpatient insulin use in type 2 diabetes mellitus and acute respiratory distress syndrome outcomes:A retrospective cohort study

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World Journal of Clinical Cases 2024年第17期12卷 2966-2975页

作者： Georges Khattar samer Asmar Laurence Aoun Fares Saliba Shaza Almardini Saif Abu Baker Catherine Hong Carolla El Chamieh Fadi Haddadin Toni Habib Omar Mourad Zeina Morcos Fatema Arafa Jonathan Mina Khalil El Gharib Mohammad Aldalahmeh Salman Khan Elie Bou Sanayeh Department of Medicine Holy Spirit University of KaslikJounieh 00000Lebanon Department of Internal Medicine Staten Island University HospitalStaten IslandNY 10305United States Public Heath and Biostatistics Independent ResearchBeirut 0000Lebanon Department of Medicine Lebanese UniversityBeirut 00000Lebanon Department of Medicine University of BalamandBeirut 00000Lebanon Department of Medicine Lebanese American UniversityBeirut 00000Lebanon Department of Medicine Northwell Health Staten Island University HospitalNew YorkNY 10305United States

BACKGROUND The impact of type 2 diabetes mellitus(T2DM)on acute respiratory distress syndrome(ARDS)is debatable.T2DM was suspected to reduce the risk and complications of ARDS.However,during coronavirus disease 2019(COVID-19),T2DM predisposed patients to ARDS,especially those who were on insulin at home.AIMTo evaluate the impact of outpatient insulin use in T2DM patients on non-COVID-19 ARDS outcomes.METHODS We conducted a retrospective cohort analysis using the Nationwide Inpatient Sample database.Adult patients diagnosed with ARDS were stratified into insulin-dependent diabetes mellitus(DM)(IDDM)and non-insulindependent DM(NIDDM)groups.After applying exclusion criteria and matching over 20 variables,we compared cohorts for mortality,duration of mechanical ventilation,incidence of acute kidney injury(AKI),length of stay(LOS),hospitalization costs,and other clinical outcomes.RESULTS Following 1:1 propensity score matching,the analysis included 274 patients in each group.Notably,no statistically significant differences emerged between the IDDM and NIDDM groups in terms of mortality rates(32.8%vs 31.0%,P=0.520),median hospital LOS(10 d,P=0.537),requirement for mechanical ventilation,incidence rates of sepsis,pneumonia or AKI,median total hospitalization costs,or patient disposition upon discharge.CONCLUSION Compared to alternative anti-diabetic medications,outpatient insulin treatment does not appear to exert an independent influence on in-hospital morbidity or mortality in diabetic patients with non-COVID-19 ARDS.

关键词： Acute respiratory distress syndrome Type 2 diabetes mellitus Insulin Length of stay Mortality Endotracheal intubation Acute kidney injury Coronavirus disease 2019