Current status of outpatient heart failure management in Egypt and recommendations for the future.

Heart failure (HF) represents one of the greatest healthcare burdens worldwide, and Egypt is no exception. HF healthcare programmes in Egypt still require further optimization to enhance diagnosis and management of the disease. Development of specialized HF clinics (HFCs) and their incorporation in the healthcare system is expected to reduce HF hospitalization and mortality rates and improve quality of care in Egypt.

Bothrops lanceolatus snake venom impairs mitochondrial respiration and induces DNA release in human heart preparation.

Introduction: Envenomations by Bothrops snakebites can induce overwhelming systemic inflammation ultimately leading to multiple organ system failure and death. Release of damage-associated molecular pattern molecules (DAMPs), in particular of mitochondrial origin, has been implicated in the pathophysiology of the deregulated innate immune response.

Objective: To test whether whole Bothrops lanceolatus venom would induce mitochondrial dysfunction and DAMPs release in human heart preparations.

[Epidemic of measles in the Verviers area (Belgium) : management and precautions at the reception in the emergency department].

Measles is a highly contagious viral disease. Transmission occurs from person to person through direct contact or by aerosolization of pharyngeal secretions. In the area of Verviers (Belgium), we were confronted to a group of patients with measles, a public health event with local concentration.

Forearm bone mineralization in recently diagnosed female adolescents with a premenarchal onset of anorexia nervosa.

Objective: Data available on bone mineralization by peripheral quantitative computed tomography (pQCT) in adolescents with an early onset anorexia nervosa (AN) is limited. We investigated whether a disturbed bone mineralization can be observed at the distal radius in recently diagnosed female adolescents with AN and a premenarchal onset of this disease.

Method: Twenty-four premenarchal patients with AN and 22 healthy females which were age and height matched, were selected from our reference database; both groups underwent a pQCT bone assessment at the distal radius of the nondominant arm.

Using Magnetic Resonance for Predicting Femoral Strength: Added Value with respect to Bone Densitometry.

Background And Purpose: To evaluate the added value of MRI with respect to peripheral quantitative computed tomography (pQCT) and dual energy X-ray absorptiometry (DXA) for predicting femoral strength.

Material And Methods: Bone mineral density (BMD) of eighteen femur specimens was assessed with pQCT, DXA, and MRI (using ultrashort echo times (UTE) and the MicroView software). Subsequently biomechanical testing was performed to assess failure load.

[Negative pressure pulmonary oedema and pulmonary haemorrhage following upper airway obstruction].

Although well described in the literature, negative pressure pulmonary oedema is an uncommon and often unrecognized pathology. It dramatically develops in healthy subjects, following a sudden obstruction of the upper airway. The strongly negative intra thoracic pressures developed during the inspiratory efforts is then responsible for the formation of pulmonary oedema secondary to increased pulmonary blood volume and hydrostatic pressure.

Fracture of human femur tissue monitored by acoustic emission sensors.

The study describes the acoustic emission (AE) activity during human femur tissue fracture. The specimens were fractured in a bending-torsion loading pattern with concurrent monitoring by two AE sensors. The number of recorded signals correlates well with the applied load providing the onset of micro-fracture at approximately one sixth of the maximum load.

Quantitative bone ultrasound at the distal radius in adults with cystic fibrosis.

It is of clinical importance to identify bone disease related to cystic fibrosis (CF) early in its course to allow therapeutic interventions that optimize bone health. To test the technical (precision) and clinical (percentage of abnormal results, correlation with clinical parameters) performance of a commercial quantitative ultrasound apparatus for radial measurements, speed of sound (SOS) was measured at the distal third of the left radius with the Omnisense 7000p apparatus (Sunlight Medical, Tel-Aviv, Israel) in a group of young adult CF patients with regular follow-up at the Brussels and Ghent University Hospital. Sixty-three (37 males) CF patients at a median (range) age of 23.

Wave dispersion and attenuation on human femur tissue.

Cortical bone is a highly heterogeneous material at the microscale and has one of the most complex structures among materials. Application of elastic wave techniques to this material is thus very challenging. In such media the initial excitation energy goes into the formation of elastic waves of different modes.

Cylinders or walls? A new computational model to estimate the MR transverse relaxation rate dependence on trabecular bone architecture.

Objective: Bone density is distributed in a complex network of interconnecting trabecular plates and rods that are interspersed with bone marrow. A computational model to assess the dependence of the relaxation rate on the geometry of bone can consider the distribution of bone material in the form of two components: cylinders and open walls (walls with gaps). We investigate whether the experimentally known dependence of the transverse relaxation rate on the trabecular bone structure can be usefully interpreted in terms of these two components.

Trabecular bone mineral density and bone geometry of the distal radius at completion of pubertal growth in childhood type 1 diabetes.

Aim: To identify disease-related risk factors for an altered bone mineral density (BMD) and geometry at young adulthood in patients with diabetes mellitus type 1 (DM1).

Methods: Fifty-six DM1 patients (23 females, 33 males) with prepubertal onset of diabetes were studied after completion of skeletal growth. Bone parameters at the distal radius were investigated by peripheral quantitative computed tomography.

Comparative bone status assessment by dual energy X-ray absorptiometry, peripheral quantitative computed tomography and quantitative ultrasound in adolescents and young adults with cystic fibrosis.

Purpose: Quantitative ultrasound bone sonometry (QUS) might be a promising screening method for cystic fibrosis (CF)-related bone disease, given its absence of radiation exposure, portability of the equipment and low cost.The value of axial transmission forearm QUS in detecting osteopenia in CF was therefore studied.

Methods: We investigated the application of QUS in the evaluation of bone status in a group of 64 adolescents (>12 years) and young adults (<40 years) with CF in a comparison with a dual X-ray absorptiometry (DXA) of the whole body and peripheral quantitative computed tomography (pQCT) of the radius at 4% and 66% sites.

Direct measurement of tibial cortical bone surface area.

Cortical bone surface area estimation is generally performed by analysis of medical images but its accuracy has not yet been verified by direct bone measurements. This study was performed to evaluate the reproducibility of direct ex vivo estimations of cross sectional tibial cortical bone surface area. Ten tibiae were evaluated by two observers using direct 3D-digitization at 38 and 66% of total tibial length using a 'critical' and a 'general' criterion for differentiation between cortical and cancellous bone.

Accuracy of peripheral quantitative computed tomography and magnetic resonance imaging in assessing cortical bone cross-sectional area: a cadaver study.

Objective: The present study aimed to assess the accuracy of peripheral quantitative computed tomography (pQCT) and magnetic resonance imaging (MRI) in assessing the cortical cross-sectional area (CCSA) at the level of the tibia.

Methods: Nine human whole-leg specimens were scanned with pQCT and MRI (T1-weighted and ultrashort echo-time [UTE] images) at 2 diaphyseal levels, 1 distal and the other 1 proximal. Subsequently, the bones were cut, and the CCSA was measured using digitized planimetry on the transverse sections.

Baseline inflammation is not predictive of periprocedural troponin elevation after elective percutaneous coronary intervention.

High-sensitivity C-reactive protein predicts future cardiovascular events in both healthy individuals and patients with unstable and stable coronary syndromes. Few data are available about the incidence and the relation to inflammation of troponin elevation following percutaneous coronary intervention (PCI), a potential predictor of longterm outcome. We sought to confirm the impact of embolization on long-term outcome and evaluate the ability of baseline inflammation to predict troponin elevation induced by PCI.

Well-nourished cystic fibrosis patients have normal mineral density, but reduced cortical thickness at the forearm.

Unlabelled: Our goal was to assess mineral density and geometry of the cortex at the level of the forearm in adolescents and young adults with cystic fibrosis, using peripheral quantitative computed tomography. We found that density was normal, but cortical thickness significantly reduced, as well in males as in females.

Introduction: Our goal was to measure bone mineral density as a volumetric density, as well as total cross-sectional area, cortical area and cortical thickness, using peripheral quantitative computed tomography (pQCT) at the forearm in adolescents and young adults with cystic fibrosis.

OPG, RANK-L, bone metabolism, and BMD in patients on peritoneal dialysis and hemodialysis.

Objectives: Bone turnover is regulated locally by osteoprotegerin (OPG) and receptor activator of NFkappaB ligand (RANK-L); it is not known how the circulating concentrations of these cytokines reflect renal osteodystrophy.

Methods: We measured serum OPG, RANK-L, parathyroid hormone (iPTH), collagen C-terminal cross-linked telopeptide (betaCrossLaps), and bone densitometry (BMD) in 79 patients with end-stage renal disease (ESRF) undergoing dialysis. A hand X-ray of these patients was also analyzed.

Between-centre variability versus variability over time in DXA whole body measurements evaluated using a whole body phantom.

This study aimed to compare the variability of whole body measurements, using dual energy X-ray absorptiometry (DXA), among geographically distinct centres versus that over time in a given centre. A Hologic-designed 28 kg modular whole body phantom was used, including high density polyethylene, gray polyvinylchloride and aluminium. It was scanned on seven Hologic QDR 4500 DXA devices, located in seven centres and was also repeatedly (n=18) scanned in the reference centre, over a time span of 5 months.

Whole body bone mineral content is similar at discharge from the hospital in premature infants receiving fortified breast milk or preterm formula.

Background: Prematurely born infants, especially those with very low birth weight (<1500 g) are at risk for metabolic bone disease.

Objectives: The influence of the type of oral feeding regimen and of other potential determinants of whole bone mineral content in prematurely born infants, when they approached full gestation, were evaluated. Previous studies have mainly examined effects at the level of regional bone.

Predictors of early and late outcome of percutaneous coronary intervention in octogenarians.

Objective: To evaluate the short and long-term results of percutaneous coronary interventions (PCI) in patients aged 80 years or older and to identify predictors of event-free survival.

Methods And Results: Clinical and angiographic data from all patients undergoing percutaneous coronary intervention in our institution are prospectively collected and stored in a computerized database. The clinical and angiographic characteristics of all patients aged 80 years or older undergoing percutaneous coronary intervention between January 1994 and December 1999 were analysed retrospectively.

[Cardiovascular rehabilitation].

In industrialized countries, coronary artery disease is the leading cause of mortality. Cardiovascular rehabilitation is one of the most important components of secondary prevention and is mainly prescribed after acute myocardial infarction or coronary artery revascularization. The aims of rehabilitation are not only the improvement of functional capacity but also the correction of risk factors and assistance to social and professional reintegration.

Cafeteria diet-induced obesity is associated with a low spontaneous growth hormone secretion and normal plasma insulin-like growth factor-I concentrations.

Pituitary growth hormone (GH) secretion has been shown to be blunted in human and animal obesity. With respect to human obesity, cafeteria diet-induced obesity might be an appropriate model to study spontaneous GH secretion. In 6 cafeteria diet-overfed obese male Wistar rats and 6 control rats with chronically implanted catheters, GH levels were measured every 15 min over 6 h by standard RIA.

Quantitative ultrasound of the calcaneus with parametric imaging: correlation with bone mineral density at different sites and with anthropometric data in menopausal women.

Objective: To prospectively study the relationship of quantitative ultrasound of the calcaneus with anthromopometric variables and with bone mineral density (BMD) assessed at the level of the calcaneus as well as at other sites.

Method: Osteosonography of the non-dominant calcaneus was performed in 135 menopausal women, using a DTU-one device with parametric imaging. Broadband ultrasound attenuation (BUA) and speed of sound (SOS) were assessed.

Quantitative ultrasound of the calcaneus: an in vivo comparison with dual-energy X-ray absorptiometry and magnetic resonance imaging.

The current study was performed in a clinical setting and aimed to evaluate the relationship between quantitative ultrasound (QUS) of the calcaneus with bone mineral density (BMD) assessed with dual-energy X-ray absorptiometry (DXA) and with variables derived from magnetic resonance imaging (MRI). Thirty-two postmenopausal women (mean age 61 years) were studied at the level of the nondominant calcaneus. QUS was performed using a DTU-one device including parametric imaging and yielded speed of sound (SOS) and broadband ultrasound attenuation (BUA) data.