Background Psoriasis is a common multisystem inflammatory disease with several associated comorbidities. Serological markers to detect associated subclinical atherosclerosis in psoriatic patients are needed. We aimed to study serum endocan levels in psoriasis vulgaris and its relation to severity of psoriasis, systemic inflammation, associated atherosclerosis, obesity, and the possible factors affecting its level in psoriatic patients.Methods This study was conducted on 30 moderate-severe psoriasis vulgaris patients and 30 healthy controls. Body mass index, body fat percent, and PASI assessments were done. Serum endocan and tumor necrosis factor-a levels were measured by ELISA.Carotid artery intima-media thickness measurement by high-resolution ultrasound was performed.Results Psoriasis patients showed significantly higher serum tumor necrosis factor-a and endocan levels (P1 = 0.008, P2 = 0.003). Additionally, there was a statistically significant difference between mean carotid artery intima-media thickness of both groups (P = 0.005). Serum endocan levels positively correlated with PASI score (P = 0.002), tumor necrosis factor-a levels (P < 0.001), mean carotid artery intima-media thickness (P = 0.001), and body mass index (P < 0.001) in the patients group. Additionally, the age of onset of disease negatively correlated with serum endocan (P = 0.003).Conclusion Serum endocan is a promising marker of severity of psoriasis and associated atherosclerosis. Early onset psoriasis is associated with higher serum endocan levels. Body mass index is positively correlated with serum endocan levels. The positive correlation of endocan and tumor necrosis factor-a supports the regulatory effect of the cytokine on endocan production and suggests the role of endocan as an inflammatory marker.
Background The aim of this study was to highlight the typical and atypical chest CT imaging features at first presentation in 120 patients who were proved to be COVID-19 by PCR and to correlate these findings with the need for ICU admission, ventilation, and mortality. We retrospectively included 120 patients 71 males (59.2%) and 49 females (40.8%) with a mean age of 47.2 ± 14.4 years. Patients subjected to clinical assessment, CBC, PCR for COVID-19, and non-contrast CT chest at first presentation. Typical and atypical imaging findings were reported and correlated with the clinical findings of the patients, the need for ICU admission, ventilation, and mortality. Results Clinically, fever was seen in 112 patients followed by dry cough in 108 patients and malaise in 35 patients. The final outcome was complete recovery in 113 cases and death in 7 cases. Typical CT findings included bilateral peripheral ground-glass opacities (GGO) in 74.7%, multilobar affection in 92.5% while atypical findings such as homogeneous consolidation, pleural effusion, mediastinal lymphadenopathy, and single lobar affection were found in 13.4, 5, 6.7, and 7.5% respectively. A statistically significant association between the presence of white lung, pleural effusion, peripheral GGO, and the need for ICU admission as well as mechanical ventilation was noted. The death was significantly higher among elderly patients; however, no significance was found between the imaging features and mortality. Conclusion CT features at first presentation can predict the need for ICU admission and the need for ventilation but cannot predict the mortality outcome of the patients.
Endothelial dysfunction is reported in erectile dysfunction (ED) and cardiovascular disease (CVD). Endocan is a serum marker in some endothelial-related disorders. Thirty patients with erectile dysfunction (Group A) and 15 controls (Group B) were enrolled in the study. Group A is subdivided into Group AI including 15 diabetic patients with ED and group AII including 15 nondiabetic patients with ED. The erectile function was assessed in all subjects using International Index of Erectile Function (IIEF-5) score. Fasting blood sugar (FBS), cholesterol and triglycerides (TG), serum endocan and carotid intima-media thickness (cIMT) were assessed in all subjects. Penile Doppler ultrasound was carried out for Group A. IIEF-5 score, serum endocan level and cIMT were significantly different between the groups. Serum endocan was positively correlated with cIMT (r = 0.342, p = 0.22) and negatively correlated with peak systolic velocity (r = -0.588, p = 0.001) and IIEF (r = -0.532, p < 0.001) although lack of correlation was detected with end-diastolic velocity, TG and cholesterol. ROC curve assessment yielded a serum endocan cut-off point of >2,392.7 ng/ml to predict the cIMT in ED patients with 83.33% sensitivity and 66.67% specificity (AUC 0.741, 95% CI 0.558-0.867). Serum endocan can correlate with ED severity and cIMT. In addition, it has a predictive value for cardiovascular risk in ED patients.
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Background Due to changes in the gastrointestinal system in geriatric people, there are higher rates of atypical presentations of common disorders. In order to decrease the mortality rate, an efficient and correct diagnosis should be given for these patients. The aim of this study was to assess the role of MDCT in evaluating gastrointestinal tract-related acute abdominal pain in geriatric patients. Results Among fifty geriatric patients presented clinically with acute abdominal pain of gastrointestinal origin from November 2019 to September 2020, mean age was 70.2 ± 5.6 years ranging from 65 to 86 years. Majority were female, (thirty patients, 60%). Gastric causes (16%): obstruction (62.5%) and perforation (37.5%); and intestinal causes (84%): obstruction (71.4%), inflammatory (28.6%), perforation (23.8%), vascular (11.9%), and others (2.4%) were the frequent causes of acute abdominal pain in the studied patients. MDCT had a very high sensitivity of 98% (95% CI) as well as its PPV (95% CI) was 100% in the evaluation of gastrointestinal-related acute abdominal pain. Conclusion MDCT is a reliable diagnostic imaging modality for geriatric patients presented with acute abdominal pain suggested to be of gastrointestinal origin with a very high sensitivity in diagnosing the causative pathological conditions. MDCT can efficiently differentiate between obstructive, inflammatory, perforated, and ischemic bowel disorders.
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