Atopic dermatitis (AD) and psoriasis are inflammatory skin diseases. AD is characterized by immune dysregulation and barrier impairment, while psoriasis is by immune dysfunction and resultant keratinocyte hyper-proliferation.    Caffeine has shown effective in ameliorating the symptoms of both diseases, but it is not conclusive through which pathways. The aim of this study was to provide a detailed discussion of available work on this topic, as well as known modes of action of caffeine that are relevant to these two conditions.    After an extensive review of the literature, we found that both diseases have decreased intracellular cyclic adenosine monophosphate (cAMP) levels in cutaneous leukocytes, so it is very likely that being a methylxanthine, and hence a phosphodiesterase (PDE) inhibitor, caffeine raises intracellular cAMP levels, which suppresses inflammatory pathways and potentiates anti-inflammatory ones. Moreover, caffeine is known to be an ATR (ataxia-telangiectasia mutated) kinase and an ATM (ATM- and Rad3-Related) kinase inhibitor, which promotes prompt apoptosis of damaged cells. It was also found to have anti-necrotic effects in reactive oxygen species (ROS)-damaged cells. These pro-apoptotic and anti-necrotic properties may also be reducing the inflammation. Finally, caffeine's metabolites have shown antioxidising effects against ROS, which certainly would reduce inflammation caused by lipid peroxidation, DNA damage and organelle destruction.    We find that caffeine acts in a number of ways to improve symptoms of inflammation and that it is an effective adjunct to therapy in AD and psoriasis.

We report the prevalence of coronary artery disease (CAD) in asymptomatic patients with end-stage kidney disease (ESKD) on hemodialysis and explore the best revascularization strategies prior to kidney transplantation. This is a retrospective single-center study, which included all patients who were candidates for kidney transplantation and underwent coronary angiography between 2003 and 2018. All included patients underwent coronary angiography without noninvasive testing and were asymptomatic cardiac-wise. Out of the 368 patients with ESRD, 45% had coronary vessel disease, 17% had 3-vessel disease, 11% had 2-vessel disease, 5.2% had significant left main artery narrowing, and 17% had single-vessel disease. Patients with 3-vessel disease had the worst survival rate at 5 and 10 years. The patients with significant 3-vessel disease or left main artery involvement underwent revascularization; 19% underwent coronary artery bypass grafting, 5% had stenting of the coronary arteries, and 4.7% were on maximal medical therapy. The patients who underwent stenting had a better survival than those on medical therapy, but the difference was not significant ( P = .445). Our findings reflect a high prevalence of CAD in patients with ESKD. There is a need for further studies to evaluate benefits of cardiovascular screening in this patient population.

Candida auris is a relatively new species of the Candida genus that is rapidly spreading in healthcare institutions across the globe. It is exceedingly difficult to identify with standard laboratory procedures and is challenging to treat due to its resistance to most antifungals. Moreover, it quickly colonizes on the surfaces in hospitals and ICUs and causes repeated infections, despite regular hospital disinfection. This grim occurrence of multidrug-resistant yeast has now become imperative to report, as its true prevalence remains unclear. Only some reports have been published in Saudi Arabia and here we present a case of C. auris candidemia identified in our hospital.

Mahdi et al. This is an open access article distributed under the terms of the Creative Commons Attribution License CC-BY 4.0., which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Background: Hypertension is a widely prevalent condition associated with significant morbidity and premature mortality, primarily because it is a risk factor for CVDs. The aim of this study was to estimate the trend of the burden of hypertension in Saudi Arabia in the last three decades. Methods: We conducted a systematic analysis of secondary data obtained from the Global Burden of Disease Study (GBD). We estimated sex-stratified, age-standardised and age-specific rates (per 100,000) of prevalence, deaths, and disability-adjusted years (DALYs) associated with hypertension in adults aged 20-94 years in Saudi Arabia between 1990 and 2019. Results: In Saudi Arabia, the age-standardised prevalence of hypertension increased from 87.7 cases per 100,000 in 1990 to 94.9 per 100,000 in 2019. More women than men had hypertension throughout the past three decades. The death and DALYs rate, however, decreased during this time. In 1990, 9.2 deaths per 100,000 in women and 3.0 deaths per 100,000 in men were due to hypertension; the respective rates declined to 6.5 and 2.8 in 2019. While the rates of DALYs in women declined steadily from 211.7 to 151.8 per 100,000 DALYs between 1990 and 2019, the rate in males did not decline considerably. The burden of hypertension–prevalence, deaths, and DALYs–were greater in older people. Conclusion: The prevalence of hypertension has increased in Saudi Arabia during the last 30 years; however, death rates and DALY related to hypertension has decreased during this time. Age- and sex-specific strategies are needed to decrease the prevalence of hypertension in Saudi Arabia.