HLA-DRB1 alleles in children with post-streptococcal acute glomerulonephritis

To investigate the association between HLA-DRB1 alleles and post-streptococcal acuteglomerulonephritis (PSAGN), 32 children withPSAGN and 380 healthy subjects from the samelocality were typed for DRB1alleles usingpolymerase chain-reverse hybridization technique.Patients with PSAGN have significantly increasedfrequency of both DRB1* 03011 (46.9 vs. 19.2% incontrols, P = 0.00025) and DRB1* 1105 (31.1 vs.15.6% in controls, P = 0.0097). However, aftercorrection of P values, only the difference for DRB1*03011 remains significant (P = 0.025). Their relativerisks are significantly high [3.71, confidence interval(Cl) = 1.8-7.8, and 3.57, Cl = 1.4-8.9 respectively].No significant differences in the frequency of bothalleles arc observed among patients with differentgrades of hypertension, proteinuria or hematuria.Conclusions: DRB1* 03011, and presumably 1105,alleles confer susceptibility to PSAGN. However theseverity of the disease is not determined by these twoalleles

Hyperechogenic renal parenchyma in potential live related kidney donors: Does it justify exclusion?

The aim of this work is to asses theimportance of ultrasonic grade I echogenicity inpotential kidney donors in the absence of urinaryabnormality and with perfect renal function.Thirty four living related kidney donors with thisabnormality were included, age range between 23-48years. Ten matched healthy donors were studied ascontrols.All cases were thoroughly investigated includingmeasuring GFR by isotopic scan and estimation ofrenal reserve by dopamine and aminoacid infusion.Renal biopsy was done for 17 cases of theechogenicity group and 8 controls. Our resultsshowed that the renal reserve was comparable in bothgroups. Glomerular changes were found in 41% ofapparently normal donors and only one case ofcontrols.Conclusion: Grade I echogenicity may be sign ofunrecognised kidney disease. Renal biopsy ismandatory when such related donors are the onlyavailable

A survey of oral health in a Sudanese population

10.1186/1472-6831-12-5BMC Oral Health121

Pediatric DXA: clinical applications

Normal bone mineral accrual requires adequate dietary intake of calcium, vitamin D and other nutrients; hepatic and renal activation of vitamin D; normal hormone levels (thyroid, parathyroid, reproductive and growth hormones); and neuromuscular functioning with sufficient stress upon the skeleton to induce bone deposition. The presence of genetic or acquired diseases and the therapies that are used to treat them can also impact bone health. Since the introduction of clinical DXA in pediatrics in the early 1990s, there has been considerable investigation into the causes of low bone mineral density (BMD) in children. Pediatricians have also become aware of the role adequate bone mass accrual in childhood has in preventing osteoporotic fractures in late adulthood. Additionally, the availability of medications to improve BMD has increased with the development of bisphosphonates. These factors have led to the increased utilization of DXA in pediatrics. This review summarizes much of the previous research regarding BMD in children and is meant to assist radiologists and clinicians with DXA utilization and interpretation

İran Şahı'ndan utansınlar!

Taha Toros Arşivi, Dosya Adı: Nazım Hikmetİstanbul Kalkınma Ajansı (TR10/14/YEN/0033) İstanbul Development Agency (TR10/14/YEN/0033

Pooled analysis of WHO Surgical Safety Checklist use and mortality after emergency laparotomy

Background The World Health Organization (WHO) Surgical Safety Checklist has fostered safe practice for 10 years, yet its place in emergency surgery has not been assessed on a global scale. The aim of this study was to evaluate reported checklist use in emergency settings and examine the relationship with perioperative mortality in patients who had emergency laparotomy. Methods In two multinational cohort studies, adults undergoing emergency laparotomy were compared with those having elective gastrointestinal surgery. Relationships between reported checklist use and mortality were determined using multivariable logistic regression and bootstrapped simulation. Results Of 12 296 patients included from 76 countries, 4843 underwent emergency laparotomy. After adjusting for patient and disease factors, checklist use before emergency laparotomy was more common in countries with a high Human Development Index (HDI) (2455 of 2741, 89.6 per cent) compared with that in countries with a middle (753 of 1242, 60.6 per cent; odds ratio (OR) 0.17, 95 per cent c.i. 0.14 to 0.21, P <0001) or low (363 of 860, 422 per cent; OR 008, 007 to 010, P <0.001) HDI. Checklist use was less common in elective surgery than for emergency laparotomy in high-HDI countries (risk difference -94 (95 per cent c.i. -11.9 to -6.9) per cent; P <0001), but the relationship was reversed in low-HDI countries (+121 (+7.0 to +173) per cent; P <0001). In multivariable models, checklist use was associated with a lower 30-day perioperative mortality (OR 0.60, 0.50 to 073; P <0.001). The greatest absolute benefit was seen for emergency surgery in low- and middle-HDI countries. Conclusion Checklist use in emergency laparotomy was associated with a significantly lower perioperative mortality rate. Checklist use in low-HDI countries was half that in high-HDI countries.Peer reviewe

Global variation in anastomosis and end colostomy formation following left-sided colorectal resection

Background End colostomy rates following colorectal resection vary across institutions in high-income settings, being influenced by patient, disease, surgeon and system factors. This study aimed to assess global variation in end colostomy rates after left-sided colorectal resection. Methods This study comprised an analysis of GlobalSurg-1 and -2 international, prospective, observational cohort studies (2014, 2016), including consecutive adult patients undergoing elective or emergency left-sided colorectal resection within discrete 2-week windows. Countries were grouped into high-, middle- and low-income tertiles according to the United Nations Human Development Index (HDI). Factors associated with colostomy formation versus primary anastomosis were explored using a multilevel, multivariable logistic regression model. Results In total, 1635 patients from 242 hospitals in 57 countries undergoing left-sided colorectal resection were included: 113 (6·9 per cent) from low-HDI, 254 (15·5 per cent) from middle-HDI and 1268 (77·6 per cent) from high-HDI countries. There was a higher proportion of patients with perforated disease (57·5, 40·9 and 35·4 per cent; P < 0·001) and subsequent use of end colostomy (52·2, 24·8 and 18·9 per cent; P < 0·001) in low- compared with middle- and high-HDI settings. The association with colostomy use in low-HDI settings persisted (odds ratio (OR) 3·20, 95 per cent c.i. 1·35 to 7·57; P = 0·008) after risk adjustment for malignant disease (OR 2·34, 1·65 to 3·32; P < 0·001), emergency surgery (OR 4·08, 2·73 to 6·10; P < 0·001), time to operation at least 48 h (OR 1·99, 1·28 to 3·09; P = 0·002) and disease perforation (OR 4·00, 2·81 to 5·69; P < 0·001). Conclusion Global differences existed in the proportion of patients receiving end stomas after left-sided colorectal resection based on income, which went beyond case mix alone

Metal Halide Perovskite and Phosphorus Doped g-C<inf>3</inf>N<inf>4</inf> Bulk Heterojunctions for Air-Stable Photodetectors

In this work, we fabricate photodetectors made of methylammonium lead trihalide perovskite (MLHP) and phosphorus-doped graphitic carbon nitride nanosheets (PCN-S). Using thermal polymerization, PCN-S with a reduced band gap, are synthesized from low-cost precursors, making it feasible to form type-II bulk heterojunctions with perovskites. Owing to the bulk heterojunctions between PCN-S and MLHP, the dark current of the photodetectors significantly decreases from ∼10-9 A for perovskite-only devices to ∼10-11 A for heterojunction devices. As a result, not only does the on/off ratio of the hybrid devices increase from 103 to 105 but also the photodetectivity is enhanced by more than 1 order of magnitude (up to 1013 Jones) and the responsivity reaches a value of 14 A W-1. Moreover, the hybridization of MLHP with PCN-S significantly modifies the hydrophilicity and morphology of the perovskite films, which dramatically increases their stability under ambient conditions. The hybrid photodetectors, described here, present a promising new direction toward stable and efficient optoelectronic applications

Potential role of circulating microRNAs (486-5p, 497, 509-5p and 605) in metabolic syndrome Egyptian male patients

Mohamed Bakr Zaki,1 Ahmed Ibrahim Abulsoud,1,2 Ahmed Mohamed Elsisi,2,3 Ahmed Soliman Doghish,2,4 Ossama Abd Elmotaal Mansour,2 Ashraf Ismail Amin,5 Mahmoud Ahmed Elrebehy,4 Mohamed Yousef Mohamed,6 Mohamed Ahmed Goda61Biochemistry Department, Faculty of Pharmacy, Heliopolis University, El-Nahda, Cairo Governorate 11777, Egypt; 2Biochemistry Department, Faculty of Pharmacy, Al-Azhar University, Nasr City, Cairo, 13465, Egypt; 3Biochemistry Department, Faculty of Pharmacy, Nahda University, Beni-Suef, Egypt; 4Biochemistry Department, Faculty of Pharmacy, Badr University in Cairo, Badr City, Cairo, Egypt; 5Department of Chemical and Clinical Pathology, National Institute of Diabetes and Endocrinology, Kasr El Ainy, Cairo, Egypt; 6Clinical Pharmacy Department, Faculty of Pharmacy (boys), Al-Azhar University, Nasr City, Cairo 13465, EgyptObjective: This study aims to evaluate the expression pattern of circulating microRNAs (miR)-486-5p, miR-497, miR-509-5p, and miR-605 in the serum of metabolic syndrome (MetS) Egyptian male patients.Methods: In this study, the circulating miR-486-5p, miR-497, miR509-5p, and miR-605 were amplified and quantitatively detected by quantitative real-time polymerase chain reaction in sera of 55 MetS male patients in comparison to 20 male controls. The level of fasting plasma glucose and triacylglycerol (TAG) were measured using calorimetric assay. Blood pressure was measured using mercuric sphygmomanometer. Anthropometric measurements were done to each individual. Furthermore, MetS patients were defined according to the criteria proposed by the American Heart Association and divided into three groups according to MetS index.Results: The study was performed on three groups and a control group defined as follows: group 1: 15 MetS patients who fulfilled all diagnostic criteria of MetS; group 2: 20 MetS patients with normal blood pressure; group 3: 20 MetS patients with normal TAG levels.The levels of miRs are expressed as [median (IQR)]. miR-486-5-p and miR-497 expression were elevated in group 1 [31.9(49), p˂0.0001; 73.1(42.5), p˂0.0001], group 2 [36.4(15.7), p˂0.0001; 68.3(54.8), p˂0.0001], and group (3) [10.8(18.9), p=0.0014; 27.5(39.7), p=0.0012]. MiR-509-5p was elevated in groups 1 and 2 [501(468), p=0.0001], [309(436), p=0.0006], respectively, while normally expressed in group 3 [0.93(0.077), p=0.0001]. miR-605 was elevated in groups 1 and 3 [25.4(20.0), p=0.0018], [54.8(65.8), p˂0.0001], while normally expressed in group 2 [0.84(0.67), p˂0.0001].Conclusion: miRs (486-5p, 497, 509-5p, and 605) serum levels were higher in MetS patients than in healthy control subjects; therefore, these serum miRs can serve as early biomarkers and can be used to follow-up the prognosis of MetS.Keywords: metabolic syndrome (MetS), miR-486-5p, miR-497, miR509-5p, miR-605, metabolic syndrome index (MSI