Publications by authors named "Fares A"
Background: Sarcopenia, a key aspect of malnutrition in liver cirrhosis (LC), affects 30-70% of LC patients. Given the inconsistent results from RCTs on branched-chain amino acids (BCAAs) for treating sarcopenia in LC, we conducted a systematic review and meta-analysis to assess the efficacy and safety of BCAAs for sarcopenia management in LC patients.
Methods: A systematic review and meta-analysis synthesizing evidence from RCTs obtained from PubMed, Embase, Cochrane, Scopus, and Web of Science from inception to April 2024.
Background: While there are several scales for measuring patients' outcomes after chronic ankle instability (CAI) surgery, a study comparing the predictive ability of these scores with regard to return to sports (RTS) at the preinjury level is lacking.
Purpose/hypothesis: The purpose of this study was to compare the Ankle Ligament Reconstruction-Return to Sport After Injury (ALR-RSI), American Orthopaedic Foot and Ankle Society (AOFAS), and Karlsson scores in predicting 2-year RTS outcomes after arthroscopic treatment of CAI. It was hypothesized that ALR-RSI would be superior in predicting 2-year RTS outcomes after CAI surgery and that a quantifiable increase in this score would significantly improve RTS outcomes.
Background: The increasing prevalence of metabolic dysfunction-associated steatotic liver disease (MASLD), formerly known as non-alcoholic fatty liver disease (NAFLD), parallels the rise in sedentary lifestyles. MASLD is the most common form of steatotic liver disease (SLD), which represents the umbrella beneath which the vast majority of chronic liver diseases fall, including alcohol-related liver disease and their overlap. These conditions are the leading contributors to chronic liver disease, significantly impacting global morbidity and mortality.
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- Clinical guidelines recommend using buffered crystalloid solutions for critically ill patients, but do not specify which type, prompting a survey of physicians' preferences between acetate- and lactate-buffered solutions.* -
- An international survey of 1321 anesthesiologists and ICU physicians found that the majority used these solutions frequently, with varying availability of both types across different countries.* -
- Most physicians supported a randomized trial comparing the two solutions, rating its clinical importance as significant, but not urgent, with a median score of 5 out of 9.*
Article Synopsis
- - This study examines whether lower doses of anti-PD(L)1 agents are as effective as the standard doses for treating patients with solid tumors at a Brazilian hospital, aiming to highlight cost-effectiveness.
- - A total of 71 patients were analyzed, comparing efficacy outcomes such as clinical overall response rate, progression-free survival, and overall survival between those receiving low-dose (LD) and conventional-dose (CD) treatments.
- - Findings revealed no significant differences in treatment outcomes between LD and CD groups, suggesting that lower doses could provide a more accessible treatment option worth further investigation in future randomized trials.
Integrating the physicochemical characteristics of aquatic environments with their biotas is essential for the conservation and monitoring of biodiversity, given the sensitivity of both the biotic and the abiotic components to environmental changes linked to water quality and human activities. In the present study, we evaluate how the contributions of different taxa to beta diversity, through local and species effects, can indicate the priority sites for conservation and ecological restoration in an Amazon region impacted by bauxite mining. We also investigate how environmental conditions at local and landscape scales influence the beta diversity of the aquatic biota.
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- - The study analyzed 79 patients with severe tuberculosis-related ARDS who received ECMO treatment at 20 centers worldwide, focusing on their 90-day survival rates and related complications.
- - Results showed that 51% of patients survived for 90 days, with significant complications including major bleeding and infections; miliary TB patients had a notably higher survival rate than those with cavitary TB.
- - Factors like older age, drug-resistant TB, and higher pre-ECMO SOFA scores were identified as key predictors of mortality, suggesting that ECMO could be a valuable intervention for patients with TB-induced ARDS.
Article Synopsis
- Mental health issues among healthcare professionals in ICUs are serious, with burnout rates reaching up to 50%, and factors affecting burnout include communication and support systems.
- The 'Hello Bundle' intervention was created to combat burnout by enhancing social interactions and team cohesion, using elements like posters, email reminders, and daily greetings.
- A cluster randomized controlled trial will assess the effectiveness of the 'Hello Bundle', involving around 7,300 participants from various ICUs, comparing burnout levels before and after the intervention.
Background: Feeding intolerance is common in critically ill patients and can lead to malnutrition. Prokinetic agents may be used to enhance the uptake of nutrition. However, the evidence on the effectiveness and safety of prokinetic agents is sparse, and there is a lack of data on their use in intensive care units (ICU).
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- The study aimed to explore how specific genetic variations (CYP2C9*2, *3, VKORC1-1639 G>A, and CYP4F2*3) affect warfarin dosing in an Arab population and to compare the effectiveness of genetic versus clinical dosing algorithms during warfarin initiation.
- Involving 130 Arab patients, the research involved calculating initial warfarin doses using a clinical algorithm and subsequently using genetic data to determine more accurate dosing after a month.
- Results indicated that genetic variations significantly influenced the required warfarin dose, with genetic dosing algorithms providing more accurate dose estimates than clinical methods based on a lower median absolute error.
Article Synopsis
- Infantile-onset Pompe disease (IOPD) is a serious condition caused by a deficiency in the enzyme acid alpha-glucosidase, leading to severe heart and muscle problems that can be fatal within the first 2 years without treatment.
- Enzyme replacement therapy (ERT) with alglucosidase-alfa is crucial for treatment, but its success can be affected by factors like the patient's immune response and CRIM status.
- A case study of CRIM-negative twins treated with high-dose ERT and immune tolerance induction showed significant improvements in cardiac function and biomarkers, highlighting the importance of early intervention in managing IOPD.
Introduction: Use of albumin is suggested for some patients with shock, but preferences for its use may vary among intensive care unit (ICU) physicians.
Methods: We conducted an international online survey of ICU physicians with 20 questions about their use of albumin and their opinion towards a randomised trial among adults with shock comparing the use versus no use of albumin.
Results: A total of 1248 respondents participated, with a mean response rate of 37%, ranging from 18% to 75% across 21 countries.
Patients with concurrent heart failure (HF) and atrial fibrillation (AF) have poor outcomes. Randomized clinical trials comparing rhythm control approaches to rate control of AF have yielded conflicting results and there is a paucity of updated and comprehensive evidence summaries to inform best practice in HF patients. We therefore conducted a systematic review and meta-analysis to compare outcomes with rhythm versus rate control of AF in various subgroups of HF patients.
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- The Rapid Practice Guideline (RPG) was created to evaluate the effectiveness of ketamine for sedation in ICU patients on mechanical ventilation compared to other sedatives or usual care, while also highlighting areas for further research.
- A panel of 23 experts, including a patient representative, conducted a systematic review and meta-analysis to gather data, using a structured approach to assess the reliability and implications of the evidence collected.
- The findings indicated considerable uncertainty regarding the effects of ketamine, with low certainty about its benefits on reducing opioid use or mechanical ventilation duration; adjunct ketamine therapy did not significantly affect mortality within 28 days.
Background: This Rapid Practice Guideline (RPG) aimed to provide evidence-based recommendations for ketamine analgo-sedation (monotherapy and adjunct) versus non-ketamine sedatives or usual care in adult intensive care unit (ICU) patients on invasive mechanical ventilation (iMV) and to identify knowledge gaps for future research.
Methods: The RPG panel comprised 23 multinational multidisciplinary panelists, including a patient representative. An up-to-date systematic review and meta-analysis constituted the evidence base.
Background: Persistent mineralocorticoid receptor activation is a pathologic response in type 2 diabetes and chronic kidney disease. Whereas mineralocorticoid receptor antagonists are beneficial in reducing cardiovascular complications, direct mechanistic pathways for these effects in humans are lacking.
Methods: The MAGMA trial (Mineralocorticoid Receptor Antagonism Clinical Evaluation in Atherosclerosis) was a randomized, double-blind, placebo-controlled trial in patients with high-risk type 2 diabetes with chronic kidney disease (not receiving dialysis) on maximum tolerated renin-angiotensin system blockade.
Type 2 Diabetes mellitus (T2DM) has the potential to impair cardiac function and cause heart failure. We aimed to study the cardioprotective influence of Galactin-3 (Gal-3) inhibitor; modified citrus pectin (MCP) in isoprenaline induced myocardial infarction (MI) in T2DM rats. Forty rats were allocated into 4 groups; groups I and II served as control.
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- - The
- Mega-ROX HIE trial
- is an international study designed to compare conservative versus liberal oxygen therapy in adults with hypoxic ischaemic encephalopathy (HIE) after cardiac arrest who are on mechanical ventilation in ICU settings.
- - The
- trial aims to enroll around 4,000 participants
- and will measure all-cause mortality within 90 days from randomization as its primary outcome, alongside several secondary outcomes related to survival and hospital stay.
- - The study is structured to reduce any potential analysis bias by clearly outlining its
- protocol and statistical analysis plan
- , and aims to provide insights into effective oxygen therapies for this population.
Article Synopsis
- A study was conducted to evaluate the effects of the proton-pump inhibitor pantoprazole on critically ill patients undergoing invasive ventilation, comparing it to a placebo.
- The trial included 4,821 patients and found that pantoprazole significantly reduced the incidence of clinically important upper gastrointestinal bleeding compared to placebo (1.0% vs. 3.5%).
- However, there was no significant difference in overall mortality rates at 90 days between the pantoprazole group (29.1%) and the placebo group (30.9%).
The study thoroughly investigates nanosilver production, properties, and interactions, shedding light on its multifaceted applications. It underscores the importance of characterizing nanosilver for predicting its behavior in complex environments. Particularly, it highlights the agricultural and environmental ramifications of nanosilver uptake by plants.
View Article and Find Full Text PDFObesity is predicted to affect approximately one-quarter of children/adolescents in Saudi Arabia by 2030, but there is limited evidence regarding the perceptions, attitudes, behaviours, and barriers to effective obesity care for adolescents living with obesity (ALwO), caregivers of ALwO, and healthcare professionals (HCPs). We report data from 500 ALwO (aged 12-<18 years), 500 caregivers, and 200 HCPs surveyed in Saudi Arabia as part of the global, cross-sectional ACTION Teens study (NCT05013359). Nearly all respondents recognized that obesity has a strong impact on overall health (ALwO 88%; caregivers 85%; HCPs 90%).
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- During the COVID-19 pandemic, many ICUs paused ongoing research to prioritize studies related to the virus, but the REVISE trial continued investigating stress ulcer prophylaxis in mechanically ventilated patients.
- The trial, which compares pantoprazole against a placebo, enrolled 2,961 patients across 59 centers, despite facing disruptions in enrollment during the pandemic.
- Changes in the informed consent process included a shift to a 'consent to continue' model and an increase in telephone consent due to restrictions, leading to a slight rise in overall consent rates.