Acupuncture Efficacy in the Treatment of Persistent Primary Nocturnal Enuresis

Introduction: This study aimed to assess the therapeutic efficacy of traditional Chinese acupuncture in the treatment of persistent primary nocturnal enuresis (PNE).Methods: Fifty children and adolescents suffering from persistent PNE were recruited from the Pediatrics and Urology Outpatient Clinic of Zagazig University Hospital during the year 2010. They included 31 boys and 19 girls, with a mean age of 116± years (range 9–17 years). The children and their parents underwent thorough counseling followed by two courses of treatment, each course administered over 10 consecutive days. Patients were instructed to continue regular follow-up, every three months, after starting the therapy. The response rate (cure, improvement, or failure) was monitored by recording dry nights and the number of spontaneous arousals to void per week on a calendar. Children who showed partial or no response after six months of observation received another two courses of acupuncture therapy, and were followed up for a further six months period.Results: After the initial two courses of treatment, the cure rate at six months was 76% with an additional 18% achieving partial improvement. Twelve children needed another two courses of treatment. After one year of follow-up, 92% of patients showed complete cure and 8% showed failure of acupuncture therapy.Conclusion: Acupuncture treatment in patients with PNE appears effective in increasing the percentage of dry nights, with stable results even after the end of treatment courses. Further controlled studies are needed to confirm these results and to elucidate the therapeutic mechanism of acupuncture.Keywords: Acupuncture Therapy; Nocturnal Enuresis; Traditional Medicin

Detection and molecular characterization of vancomycin resistant Staphylococcus aureus from clinical isolates

Until now, few strains of vancomycin resistant Staphylococcus aureus (VRSA) have been reported worldwide. The disk diffusion method for determination of vancomycin sensitivity frequently misclassifies intermediately susceptible isolates to fully susceptible. However, non-automated minimum inhibitory concentration (MIC) detection methods are the gold standards. In the present study, 439 Gram positive clinical isolates were collected. Among them, 220 Staphylococcus aureus were identified. Multiplex polymerase chain reaction (PCR) detection method for vancomycin resistant S. aureus (VRSA) was developed for detection of both vanA gene (for vancomycin resistance) and nuc gene (specific for S. aureus) in a single step PCR compared to conventional non-automated disc diffusion and MIC detection methods. Molecular typing of VRSA isolates was performed using randomly amplified polymorphic (RAPD) DNA assay technique. The results show 10 VRSA isolates detected by disc diffusion method and MIC determination. Five out of them harbored vanA gene that were detected by multiplex PCR and most of them showed low clonal diversity.Key words: Molecular characterization, multiplex polymerase chain reaction (PCR), vancomycin resistant Staphylococcus aureus (VRSA), vanA gene, nuc gene, randomly amplified polymorphic DNA (RAPD) assay technique

Effective treatment with rituximab for the maintenance of remission in frequently relapsing minimal change disease

AIM: Treatment of frequently relapsing or steroid-dependent minimal change disease (MCD) in children and adults remains challenging. Glucocorticoids and/or other immunosuppressive agents are the mainstay of treatment, but patients often experience toxicity from prolonged exposure and may either become treatment dependent and/or resistant. Increasing evidence suggests that rituximab (RTX) can be a useful alternative to standard immunosuppression and allow withdrawal of maintenance immunosuppressants; however, data on optimal treatment regimens, long-term efficacy and safety are still limited. METHODS: We undertook a prospective study of RTX to allow immunosuppression minimization in 15 young adults with frequently relapsing or steroid-dependent, biopsy-proven MCD. All patients were in remission at the start of treatment and on a calcineurin inhibitor. Two doses of RTX (1 gr) were given 6 months apart. A subset of patients also received an additional dose 12 months later, in order to examine the benefit of re-treatment. Biochemical and clinical parameters were monitored over an extended follow-up period of up to 43 months. RESULTS: Median steroid-free survival after RTX was 25 months (range 4-34). Mean relapse frequency decreased from 2.60 ± 0.28 to 0.4 ± 0.19 (P < 0.001) after RTX. Seven relapses occurred, five of which (71%) when CD19 counts were greater than 100 µ. Immunoglobulin levels remained unchanged, and no major side effects were observed throughout the follow-up period. CONCLUSIONS: Rituximab therapy is effective at maintaining prolonged steroid-free remission and reducing relapse frequency in this group of patients. Our study lends further support for the role of RTX in the treatment of patients with frequently relapsing or steroid-dependent MCD

Stress among Mansoura (Egypt) baccalaureate nursing students

Background: Over the last years, details regarding levels of stress and sources of stress have emerged in studies of nursing students in Western population To date, there only few similar reports on clinical stress, anxiety, depression among the Arab population .This study was conducted to examine the level of perceived stress among baccalaureate Mansoura nursing students and to highlight the possible predicting factors. Methods: In this cross- sectional study, Data were obtained from 373 students using a self-administered questionnaire, including questions on sociodemographics, list of possible stressors, perceived stress, physical wellbeing factors, anxiety and depressive symptoms. Results: Prevalence of high stress level, anxiety and depression were 40.2%, 46.6% and 27.9%, respectively. On average each student reported a mean of 4.6 stressors and academic pressures were the most frequent stressors .In regression analysis the number of stressors and global sickness index score were predictors of high stress level. Conclusion: These findings call for introduction of stress management programs and psychiatric care into nursing health services of the University.Key words: Nursing students, stress, Depression, Anxiety, Arab culture, Egyp

On-Line Detection And Measurement Of Partial Discharge Signals In A Noisy Environment

In extracting partial discharge (PD) signals embedded in excessive noise, the need for an online and automated tool becomes a crucial necessity. One of the recent approaches that have gained some acceptance within the research arena is the Wavelet multi-resolution analysis (WMRA). However selecting an accurate mother wavelet, defining dynamic threshold values and identifying the resolution levels to be considered in the PD extraction from the noise are still challenging tasks. This paper proposes a novel wavelet-based technique for extracting PD signals embedded in high noise levels. The proposed technique enhances the WMRA by decomposing the noisy data into different resolution levels while sliding it into Kaiser's window. Only the maximum expansion coefficients at each resolution level are used in de-noising and measuring the extracted PD signal. A small set of coefficients is used in the monitoring process without assigning threshold values or performing signal reconstruction. The proposed monitoring technique has been applied to a laboratory data as well as to a simulated PD pulses embedded in a collected laboratory noise

Expression and DNA methylation of TNF, IFNG and FOXP3 in colorectal cancer and their prognostic significance.

BACKGROUND: Colorectal cancer (CRC) progression is associated with suppression of host cell-mediated immunity and local immune escape mechanisms. Our aim was to assess the immune function in terms of expression of TNF, IFNG and FOXP3 in CRC. METHODS: Sixty patients with CRC and 15 matched controls were recruited. TaqMan quantitative PCR and methylation-specific PCR was performed for expression and DNA methylation analysis of TNF, IFNG and FOXP3. Survival analysis was performed over a median follow-up of 48 months. RESULTS: TNF was suppressed in tumour and IFNG was suppressed in peripheral blood mononuclear cells (PBMCs) of patients with CRC. Tumours showed enhanced expression of FOXP3 and was significantly higher when tumour size was >38 mm (median tumour size; P=0.006, Mann-Whitney U-test). Peripheral blood mononuclear cell IFNG was suppressed in recurrent CRC (P=0.01). Methylated TNFpromoter (P=0.003) and TNFexon1 (P=0.001) were associated with significant suppression of TNF in tumours. Methylated FOXP3cpg was associated with significant suppression of FOXP3 in both PBMC (P=0.018) and tumours (P=0.010). Reduced PBMC FOXP3 expression was associated with significantly worse overall survival (HR=8.319, P=0.019). CONCLUSIONS: We have detected changes in the expression of immunomodulatory genes that could act as biomarkers for prognosis and future immunotherapeutic strategies

Ruminant Brucellosis in the Kafr El Sheikh Governorate of the Nile Delta, Egypt: Prevalence of a Neglected Zoonosis

Brucellosis is a zoonosis of mammals caused by bacteria of the genus Brucella. It is responsible for a vast global burden imposed on human health through disability and on animal productivity. In humans brucellosis causes a range of flu-like symptoms and chronic debilitating illness. In livestock brucellosis causes economic losses as a result of abortion, infertility and decreased milk production. The main routes for human infection are consumption of contaminated dairy products and contact with infected ruminants. The control of brucellosis in humans depends on its control in ruminants, for which accurate estimates of the frequency of infection are very useful, especially in areas with no previous frequency estimates. We studied the seroprevalence of brucellosis and its geographic distribution among domestic ruminants in one governorate of the Nile Delta region, Egypt. In the study area, the seroprevalence of ruminant brucellosis is very high and has probably increased considerably since the early 1990s. The disease is widespread but more concentrated around major animal markets. These findings question the efficacy of the control strategy in place and highlight the high infection risk for the animal and human populations of the area and the urgent need for an improved control strategy

A Critical Assessment of the Effects of Bt Transgenic Plants on Parasitoids

The ecological safety of transgenic insecticidal plants expressing crystal proteins (Cry toxins) from the bacterium Bacillus thuringiensis (Bt) continues to be debated. Much of the debate has focused on nontarget organisms, especially predators and parasitoids that help control populations of pest insects in many crops. Although many studies have been conducted on predators, few reports have examined parasitoids but some of them have reported negative impacts. None of the previous reports were able to clearly characterize the cause of the negative impact. In order to provide a critical assessment, we used a novel paradigm consisting of a strain of the insect pest, Plutella xylostella (herbivore), resistant to Cry1C and allowed it to feed on Bt plants and then become parasitized by Diadegma insulare, an important endoparasitoid of P. xylostella. Our results indicated that the parasitoid was exposed to a biologically active form of the Cy1C protein while in the host but was not harmed by such exposure. Parallel studies conducted with several commonly used insecticides indicated they significantly reduced parasitism rates on strains of P. xylostella resistant to these insecticides. These results provide the first clear evidence of the lack of hazard to a parasitoid by a Bt plant, compared to traditional insecticides, and describe a test to rigorously evaluate the risks Bt plants pose to predators and parasitoids

A panel of kallikrein markers can predict outcome of prostate biopsy following clinical work-up: an independent validation study from the European Randomized Study of Prostate Cancer screening, France

<p>Abstract</p> <p>Background</p> <p>We have previously shown that a panel of kallikrein markers - total prostate-specific antigen (PSA), free PSA, intact PSA and human kallikrein-related peptidase 2 (hK2) - can predict the outcome of prostate biopsy in men with elevated PSA. Here we investigate the properties of our panel in men subject to clinical work-up before biopsy.</p> <p>Methods</p> <p>We applied a previously published predictive model based on the kallikrein panel to 262 men undergoing prostate biopsy following an elevated PSA (≥ 3 ng/ml) and further clinical work-up during the European Randomized Study of Prostate Cancer screening, France. The predictive accuracy of the model was compared to a "base" model of PSA, age and digital rectal exam (DRE).</p> <p>Results</p> <p>83 (32%) men had prostate cancer on biopsy of whom 45 (54%) had high grade disease (Gleason score 7 or higher). Our model had significantly higher accuracy than the base model in predicting cancer (area-under-the-curve [AUC] improved from 0.63 to 0.78) or high-grade cancer (AUC increased from 0.77 to 0.87). Using a decision rule to biopsy those with a 20% or higher risk of cancer from the model would reduce the number of biopsies by nearly half. For every 1000 men with elevated PSA and clinical indication for biopsy, the model would recommend against biopsy in 61 men with cancer, the majority (≈80%) of whom would have low stage <it>and </it>low grade disease at diagnosis.</p> <p>Conclusions</p> <p>In this independent validation study, the model was highly predictive of prostate cancer in men for whom the decision to biopsy is based on both elevated PSA and clinical work-up. Use of this model would reduce a large number of biopsies while missing few cancers.</p