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Background: Traumatic injury of popliteal artery records the highest risk of lower extremity loss with amputation rates of 10% to 15%. A method to investigate the predictors of amputation is needed because previous scores could not be validated. The goal of this review is to investigate if POPSAVEIT (popliteal scoring assessment for vascular extremity injuries in trauma) may be used as a preoperative indicator of amputation risk in patients with traumatic injury of popliteal vessel. Methods: From 2017 to 2022, all patients who underwent surgical repair of popliteal arterial traumatic injuries at Zagazig University Hospitals were included in this retrospective study. Patients who needed amputation were assessed to those with limb salvage. Based on univariate analysis, the significant predictors of POPSAVEIT variables for amputation were included in a multivariable analysis. To determine low vs. high-risk scores, receiver operating characteristic (ROC)curve are created. Results: 76 patients were included in the study, with an overall amputation rate of 18.4%. The following risk factors were shown to be independently related with amputation: systolic blood pressure <90 mm Hg (OR, 5.3; P = 0.05), associated orthopedic injury (OR, 6.1; P = 0.009), and a lack of preoperative pedal Doppler signals (OR, 8.3; P = 0.001). For a high risk of amputation, a score of ≥3 was determined to have the best sensitivity (78.6%) and specificity (59%). Conclusions: POPSAVEIT is a preoperative simple and practical way to classify patients into low- and high-risk major amputation categories. [ABSTRACT FROM AUTHOR]

Background: Stenosis due to neointimal hyperplasia is the main reason of failing arteriovenous fistula (AVF). Percutaneous endovascular procedures are widely applied for treatment of failing dialysis circuit. Both drug-coated balloon (DCB) and non-compliant balloon (NCD) angioplasty can be employed to treat hemodialysis access dysfunction. Aim of the work: The goal of this trial is to assess the additional value of using DCB over NCB for the management of failing native AVF. Methods: This is a single-centre randomized clinical study, 53 patients presented with failing dialysis access are assessed for eligibility. The study was conducted at Vascular Surgery Department, Zagazig University Hospitals-Egypt from January 2017 to December 2020. A total of 27 patients presented with failing AVF, are randomized to 13 patients are treated with DCB and 14 patient are treated with NCB angioplasty. The primary endpoint of the study is anatomical success (less than 30% residual stenosis of the target lesion). Secondary endpoints include duplex assessment of dialysis circuit flow rate, complications (minor and major), target lesion primary patency (TLPP), target lesion assisted primary patency (TLAPP), target lesion secondary patency (TLSP), cumulative primary and assisted primary patency, as well as intervention free survival during 12 months follow up. Results: In DCB group, the mean age of 55.1 years; while the mean age in NCB group is 54.6 years. There are no preoperative differences in patient risk factors between both groups. Anatomical success rate is achieved in 100% of both groups. TLPP between DCB and NCB groups at 12 months (61.5% vs 57.1%) are comparable (P = 0.81), as well as TLAPP at 12 months (61.5% vs 64.3%; P = 0.88). TLSP between DCB and NCB at 12 months (69.2% vs 64.3%) are also comparable (P = 0.78). Successful endovascular angioplasty for all circuit restenosis are performed in one DCB patient and three NCB patients. Rates of overall fistula restenosis are higher in NCB than DCB group without significance difference. Conclusion: DCB is promising alternative for failing AVF treatment, as it clinically improves short term access patency, and reduces target lesion restenosis rate but this remains statistically insignificant. [ABSTRACT FROM AUTHOR]

Purpose: Assess reproducibility of detection, staging, and grading of non-Hodgkin lymphoma (NHL) using wholebody diffusion-weighted imaging with background body signal suppression (WB-DWIBS). Material and methods: Thirty NHL patients underwent WB-DWIBS, divided into 2 groups according to staging and grading. Image analysis and apparent diffusion coefficient (ADC) measurement of the largest lymph node in each group were performed by 2 observers. Inter-observer agreement was performed. Results: Overall inter-observer agreement for detection of NHL was excellent (k = 0.843; 92.05%) with excellent inter-observer agreement of nodal disease (cervical, thoracic and abdominal) (k = 0.783, 0.769, and 0.856; 96.67%, 90.0%, and 93.3% respectively), extra-nodal disease (k = 1; 100%), and splenic involvement (k = 0.67; 83.3%). The overall inter-observer agreement of DWIBS in staging of NHL was excellent (k = 0.90; 94.9%) with excellent inter-observer agreement for stage I (k = 0.93; 96.4%), stage II (k = 0.90; 94.8%), stage III (k = 0.89; 94.6%), and stage IV (k = 0.88; 94.0%). There was significant difference between ADC in stage I, II (0.77 ± 0.13, 0.85 ± 0.09 × 10-3 mm²/s), and stage III, IV (0.63 ± 0.08, 0.64 ± 0.11 × 10-3 mm²/s, p < 0.002, < 0.001). Interclass correlation showed almost perfect agreement for ADC measurement in staging and grading groups (r = 0.96 and r = 0.85, respectively, p < 0.001). There was significant difference between ADC in aggressive lymphoma (0.65 ± 0.1, 0.67 ± 0.13 × 10-3 mm²/s) and indolent lymphoma (0.76 ± 0.14, 0.84 ± 0.09 × 10-3 mm²/s, p < 0.028, < 0.001). Conclusion: DWIBS is reproducible for detection and staging of nodal and extra-nodal involvement in patients with NHL. ADC can quantitatively participate in the staging and grading of NHL. [ABSTRACT FROM AUTHOR]

Background: Fatigue, myalgia, and arthralgia are the typical COVID-19 musculoskeletal symptoms, but their prevalence has not been studied extensively. This study was designed to estimate the frequency of different musculoskeletal symptoms among COVID-19 patients and determine the association between the musculoskeletal symptoms and some Sociodemographic characteristics and the severity of the disease. Methods: A cross-sectional study was conducted among 160 (COVID-19) patients attended screening clinic at Zagazig university hospitals during a period from15-4-2020 to 15-7-2020, they were drown by systemic random method. Clinical assessment was done by taking of sociodemographic data, assessment of the severity of COVID symptoms and assessment of the musculoskeletal through Joint assessment and Fatigue assessment. Results: The majority of patients developed fatigue and myalgia (60.0%), arthritis, or arthralgia was reported in (47.5%, 45.0%) of patients had back pain. According to Nordic questionnaire, most of studied patients were suffering from musculoskeletal manifestations at neck, lower back, and knee (55.0%, 54.0% and 50.0%) respectively. There was a statistically significant association between arthralgia and sex distribution (p=0.0001) where (61.9%) of females had arthralgia. There was a statistically significant association between myalgia and occupation of the patients (p=0.000) where 82.4% of mentally working patients had myalgia. Binary logistic regression analysis revealed significant models for the prediction of myalgia, fatigue and arthritis/arthralgia. Conclusions: Musculoskeletal symptoms associated with COVID-19 patients are frequent mostly fatigue and myalgia followed by arthritis or arthralgia, and back pain. Patients with comorbidities were significantly associated with fatigue. Females had arthralgia more than males. Also, a high percent of mentally working patients from urban were complaining of back pain. [ABSTRACT FROM AUTHOR]

Background: Intradialytic hypertension is an underrecognized complication in hemodialysis patients, increasing cardiovascular morbidity, mortality, and hospitalization. Objective: The aim of the current work was to detect the incidence of intradialytic hypertension in hemodialysis patients and to compare the effect of high flux versus low flux dialysis on intradialytic hypertension and adequacy of dialysis. Patients and Methods: The study was conducted on 200 patients on regular hemodialysis in Beheira governorate. The patients were divided into: Group 1 including 100 patients on hemodialysis with high flux dialyzers and Group 2 including 100 patients on hemodialysis with low flux dialyzers. Results: The incidence of intradialytic hypertension in hemodialysis patients was 23.5 % at the start, 21% after one month and 13% after three months duration. There was a significant reduction in number of intradialytic hypertension patients after one month duration and after three months in both groups. Adequacy of dialysis in the form of Kt/V and urea reduction ratio showed highly significant improvement by the end of the study in the high flux group. Kidney function tests, serum parathyroid hormone levels and serum hemoglobin levels showed significant improvement at the end of the study in high flux group compared to low flux group. Conclusion: It could be concluded that the current study has not demonstrated a significant difference between both groups regarding the effect on intradialytic hypertension, but adequacy of dialysis in the form of Kt/V and urea reduction ratio improved significantly by the end our study in the high flux group. [ABSTRACT FROM AUTHOR]