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Endoscopic ultrasound of asymptomatic descending thoracic aorta thrombosis


Thoracic aortic thrombus is a rare condition with only approximately 100 cases reported. Typically, this phenomenon is only diagnosed after symptomatic embolization. A 70 years old male was presented to our hospital with obstructing pancreatic head mass for endoscopic ultrasound (EUS). At the time of hospitalization there were no symptoms or signs suggesting thrombo-embolism or organ ischemia. During EUS examination, asymptomatic descending thoracic aorta thrombosis was discovered accidentally.

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Hepatitis B virus genotype E infection among Egyptian health care workers


Background and Objectives

Health Care Workers (HCWs) are at a high risk of needle stick injuries and HBV infection in Egypt; this problem is further aggravated by low Hepatitis B (HB) vaccination coverage. Limited data are available on the prevalence of HBV infection in Egyptian HCWs. In this study, we aimed to assess the HBV infection rate and genotypes among Egyptian HCWs.


Five hundred and sixty-four (564) HCWs were included. Of them, 258 (45.74%) were health care providers and 306 (54.25%) were non-health care providers. All HCWs completed both the study questionnaires and provided a blood sample for HBV testing. Indeed, all HCWs were tested for Hepatitis B surface antigen (HBsAg) and antibody to Hepatitis B core antigen (anti-HBc), by enzyme-linked immunosorbent assay. HBVDNA was checked for HCWs who tested positive for HBsAg and/or anti-HBc, by nested Polymerase Chain Reaction (PCR). HBVDNA positive HCWs were further subjected to HBV genotyping.


The mean age of included HCWs was 33.0 ± 9.8 years, of whom 319 (56.56%) were males. The mean duration of health care work was 9.3 ± 6.7 years. The frequency of HBsAg and anti-HBc were 1.4%, and 24.5%, respectively. Old age and prolonged duration of health care work were significantly associated with anti-HBc seropositivity. Among 140 HCWs positive for HBsAg and/or anti-HBc, 14 (10 %) had positive HBVDNA by PCR. HBV/E (n = 7), HBV/D (n = 3) and co-infection with E and D (n = 4) genotypes were detected.


Egyptian HCWs have a significantly high rate of HBV exposure. The detection of HBV/E genotype among Egyptian HCWs suggests prevalent transmission of HBV/E among Egyptian populations.

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Serum ghrelin level is associated with cardiovascular risk score

):1167-75. 15. YANO Y, NAKAZATO M, TOSHINAI K, INOKUCHI T, MATSUDA S, HIDAKA T, HAYAKAWA M, KANGAWA K, SHIMADA K, KARIO K. Circulating des-acyl ghrelin improves cardiovascular risk prediction in older hypertensive patients. Am J Hypertens 2014; 27 (5):727-33. 16. HAMED EA, ZAKARY MM, AHMED NS, GAMAL RM. Circulating leptin and insulin in obese patients with and without type 2 diabetes mellitus: relation to ghrelin and oxidative stress. Diabetes Res Clin Pract. 2011; 94 (3):434-41. 17. RODRÍGUEZ A, GÓMEZ-AMBROSI J, CATALÁN V, BECERRIL S, SÁINZ N, GIL MJ, SILVA

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Anaphylactic shock: are we doing enough and with the right timing and order?

testing in drug Allergy . Curr. Opin. Allergy Clin. Immunol. 2010; 10 (4): 291. 20. SIMONS FE, ARDUSSO LR, BILÒ MB, EL-GAMAL YM, LEDFORD DK, RING J, et al. World Allergy Organization anaphylaxis guidelines: summary. J Allergy Clin Immunol. Mar. 2011; 127(3):587-93.e1-22. 21. LIEBERMAN P, NICKLAS RA, OPPENHEIMER J, et al . The diagnosis and management of anaphylaxis practice parameter: 2010 update . J Allergy Clin Immunol. Sep. 2010; 126(3):477-80.e1-42. 22. JOHANSSON SG, BIEBER T, DAHL R, FRIEDMANN PS, LANIER BQ, LOCKEY RF, et al. Revised

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Pay for performance and the management of hypertension

interrupted time series analysis of hypertension management before and after the introduction of P4P. Similarly, there were no significant changes to the numbers of patients being treated with combination therapy. This trend was observed prior to implementation of P4P and was subsequently sustained. On a more positive note, they did not find evidence of gaming to achieve targets. Nationally reported data on the numbers of patients excluded from the indicator denominator through a process known as exception reporting has remained constant at approximately 3–4%, which would

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Effects of a low FODMAP diet and specific carbohydrate diet on symptoms and nutritional adequacy of patients with irritable bowel syndrome: Preliminary results of a single-blinded randomized trial

and dedicate enough time to eat them. Avoid skipping meals or fasting for long time. Avoid alcohol assumption. Table 4 Food included and excluded and advices in a specific carbohydrate diet Food included in SCD diet Food not included in SCD diet Meat, fish Chicken, eggs, turkey, meat, fish, pork, game, lamb) Ham, sausage, hot dog, wurstel, processed meats in general Vegetables All kind of fresh vegetables (Asparagus, broccoli, cabbage, cauliflower, onion, garlic, carrots, mushrooms, celery, pepper, fennel, pumpkin

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