Peanut sensitization in a group of allergic Egyptian children

<p>Abstract</p> <p>Background</p> <p>There are no published data on peanut sensitization in Egypt and the problem of peanut allergy seems underestimated. We sought to screen for peanut sensitization in a group of atopic Egyptian children in relation to their phenotypic manifestations.</p> <p>Methods</p> <p>We consecutively enrolled 100 allergic children; 2-10 years old (mean 6.5 yr). The study measurements included clinical evaluation for site of allergy, possible precipitating factors, consumption of peanuts (starting age and last consumption), duration of breast feeding, current treatment, and family history of allergy as well as skin prick testing with a commercial peanut extract, and serum peanut specific and total IgE estimation. Children who were found sensitized to peanuts were subjected to an open oral peanut challenge test taking all necessary precautions.</p> <p>Results</p> <p>Seven subjects (7%) were sensitized and three out of six of them had positive oral challenge denoting allergy to peanuts. The sensitization rates did not vary significantly with gender, age, family history of allergy, breast feeding duration, clinical form of allergy, serum total IgE, or absolute eosinophil count. All peanut sensitive subjects had skin with or without respiratory allergy.</p> <p>Conclusions</p> <p>Peanut allergy does not seem to be rare in atopic children in Egypt. Skin prick and specific IgE testing are effective screening tools to determine candidates for peanut oral challenging. Wider scale multicenter population-based studies are needed to assess the prevalence of peanut allergy and its clinical correlates in our country.</p

Antioxidant Categories and Mode of Action

Oxidative stress has received a considerable scientific attention as a mediator in the etiology of many human diseases. Oxidative stress is the result of an imbalance between free radicals and antioxidants. Cells can be damaged by free radicals that are considered to play a main role in the aging process and diseases development. Antioxidants are the first line of defense against the detrimental effects of free radical damage, and it is essential to maintain optimal health via different mechanisms of action. Types of antioxidants range from those generated endogenously by the body cells, to exogenous agents such as dietary supplements. Antioxidant insufficiency can be developed as a result of decreased antioxidant intake, synthesis of endogenous enzymes, or increased antioxidant utilization. To maintain optimal body function, antioxidant supplementation has become an increasingly popular practice through improving free radical protection. In this chapter, we first elucidate the oxidative stress, and then define the antioxidant and its categories. Finally, introduce the antioxidants mode of actions for cell protection from free radicals

Diagnostic value of CD14+ CD16+ monocytes in neonatal sepsis

Background: The majority of monocytes (MO) are strongly positive for CD14 and negative for CD16. The phenotype and function of peripheral blood monocytes change after trauma and during sepsis. CD14+CD16+ monocytes, identified as a minor population of monocytes which constitute a potent phagocytosing and antigen-presenting monocyte subpopulation that expands during acute and chronic infections. Objective: To evaluate monocyte expression of CD14 and CD16 in preterm neonates and to assess it as a possible marker for early diagnosis of neonatal sepsis as the early clinical signs are often insidious and non-specific. Methods: This study was carried out on 45 preterm neonates (1-3 days old ) with a mean gestational age of 34.5 ± 1.03 weeks . They were classified into three groups. Group I included 15 neonates with proven sepsis. Group II included 15 neonates with possible or suspected infection. Group III (control group) included 15 healthy age and sex matched neonates. The neonates with possible infection were followed up. Nine of them developed sepsis later on (proved clinically and by laboratory) and they were considered as patients with early sepsis at the time of admission. History taking and clinical examination were performed as well as laboratory investigations including, complete blood count, blood culture and sensitivity (for patients only), measurement of C-reactive protein (CRP) and CD14 and CD16 expression on monocytes by flow cytometry. Results: The proportion of CD14+ CD16+ MO within all circulating monocytes was significantly higher in patients with proven (75.2±13.1%), early (63.9±17.9%) or possible sepsis (55.1±26.8%) than controls (3.86±2.53%) (p &lt; 0.0001, p &lt; 0.0001, p &lt; 0.001, respecctively). It was higher in neonates with proven than possible sepsis (p &gt; 0.05), whereas it was comparable in the groups of proven and early sepsis (p &lt; 0.05). There was a significant positive correlation between mean fluorescence intensity (MFI) of CD16+ MO and CRP (p &lt; 0.01) and a significant negative correlation between it and the platelet count (p &lt; 0.05) among patients. When neonates with early sepsis were followed up after 48 hours a significant increase in CRP levels and MFI of CD16 expression on monocytes was noted (p &lt; 0.01 for both). The sensitivity and negative predictive value of CD14+ CD16+ MO% and MFI of CD16+ MO were higher than that of CRP. Specificity and positive predictive value of CD14+CD16+ MO% were similar to those of CRP. The cut off point (obtained from the ROC curve) for CD14+ CD16+ MO% was 8.6% and that for MFI of CD16+ MO was 9. Conclusion: The measurement of the percentage of CD14+ CD16+ MO among circulating MO is a promising rapid and sensitive test for early diagnosis of neonatal sepsis and exclusion of infection in neonates with high risk to develop sepsis. NICU costs as well as unnecessary antibiotic use can be thus reduced.Keywords: CD14, CD16, monocyte, neonate, sepsisEgypt J Pediatr Allergy Immunol 2004; 2(1): 16-2

Burnout among surgeons before and during the SARS-CoV-2 pandemic: an international survey

Background: SARS-CoV-2 pandemic has had many significant impacts within the surgical realm, and surgeons have been obligated to reconsider almost every aspect of daily clinical practice. Methods: This is a cross-sectional study reported in compliance with the CHERRIES guidelines and conducted through an online platform from June 14th to July 15th, 2020. The primary outcome was the burden of burnout during the pandemic indicated by the validated Shirom-Melamed Burnout Measure. Results: Nine hundred fifty-four surgeons completed the survey. The median length of practice was 10&nbsp;years; 78.2% included were male with a median age of 37&nbsp;years old, 39.5% were consultants, 68.9% were general surgeons, and 55.7% were affiliated with an academic institution. Overall, there was a significant increase in the mean burnout score during the pandemic; longer years of practice and older age were significantly associated with less burnout. There were significant reductions in the median number of outpatient visits, operated cases, on-call hours, emergency visits, and research work, so, 48.2% of respondents felt that the training resources were insufficient. The majority (81.3%) of respondents reported that their hospitals were included in the management of COVID-19, 66.5% felt their roles had been minimized; 41% were asked to assist in non-surgical medical practices, and 37.6% of respondents were included in COVID-19 management. Conclusions: There was a significant burnout among trainees. Almost all aspects of clinical and research activities were affected with a significant reduction in the volume of research, outpatient clinic visits, surgical procedures, on-call hours, and emergency cases hindering the training. Trial registration: The study was registered on clicaltrials.gov "NCT04433286" on 16/06/2020

Investigating temporal access in a flipped classroom: procrastination persists

Abstract This paper reports on a study that examines the learning behaviors and characteristics of students in a mobile applications computer programming class that adopted a “flipped” learning style. By harvesting learning analytics data from a learning management system, we created visualizations of work intensity to explore temporal patterns of students’ behavior and then correlate them with the students’ performance. Findings indicate that low, medium, and high performing students tend to access learning materials late with work intensity spiking on the lecture day, specifically during the lecture session. While high and low performing students show no difference in temporal access to material, medium performing students demonstrate the greatest degree of vibrancy regarding course content material access. Further a discussion of implications and insights on procrastination in the context of flipped classrooms are included

EFFECT OF SOME SELECTED DRUGS (PYREMETHAMIN,CLARITHROMYCIN, SPIRAMYCIN AND IVERMECTIN )ON EXPERIMENTAL TREATMENT OF TOXOPLASMOSIS CREATED IN MICE

In the present study, Toxoplasma gondiiwas isolated and diagnosed from human as first attempt, and then the infection was created in laboratory mice as an essential step for growing the parasite. The second step was studying the effect of some selected drugs on the experimental treatment for disease of toxoplasmosis created in the mice. The drugs are: Pyrimethamin ,Clarithromycin , Spiramycin, Ivermectin .The results of the study showed the effects of these drugs on the tissue cyst formed in the brain and lungs. The number of tissue cysts in the brain of the mouse treated with pyrimethamin was 14.8 ±1.067 after 28 days. Significant differences appeared when this result compared with the control group in which it was 27.4±1.029.The number of tissue cysts formed in lung, tissue in the mouse treated with the same drug after the same period of the time was 6.2±0.583.This showed a significant differences as compared with the control group in which it was 10.2±0.583.No significant differences appeared between both groups as for the treatment by Clarithromycin antibiotic as far as the number of the tissue cysts formed in the brain after 28 days is concerned. The number was 23.8 ±0.86 as compared with the control group 38.6±1.029.The same compared is true of the lungs, tissue. The number of the tissue cysts was 23.8±0.86 as compared with the control group 28.4±1.805.Concerning the antibiotic Spiramycin ,the results showed the effectiveness of it in decreasing the tissue cysts formed in the brain .The significant differences were (p<0.05),the rate of the cysts was 9.6±0.6 as compared with the control group in which it was 22.8±1.067.The same effectiveness appeared on the lungs, tissue as the rate of tissue cysts after 28 days of treatment was 4.6±0.509 as compared with the control group in which was 17±1.14 and the significant differences were (p=0.000).The Ivermectin drug showed a great effectiveness in minimizing the number of the tissue cysts formed in the brain and the lungs. The numbers of the tissue cysts formed after 28 days were 3.2±0.374 and 1±0.316 respectively; significant differences are observed when these numbers are compared with the numbers of the control group which were 22±1.843 and 19.4±1.435. Thus, the use of Ivermectin drug is considered as a pioneer and fruitful study since this drug has not been used for the treatment of Toxoplasmosis

Neuronal autoantibodies in a sample of Egyptian patients with drug-resistant epilepsy

Abstract Background Epilepsy is one of the most common and chronic neurological diseases. About one-third of epilepsy patients do not achieve seizure freedom despite adequate therapy with antiseizure medications (ASMs) and develop drug-resistant epilepsy (DRE). Autoimmunity is increasingly being recognized as a cause of epilepsy in those patients. Some cases are associated with antibodies against several target antigens, including neuronal extracellular proteins as well as intracellular structures. In such patients, immunotherapy may be highly effective. This study aimed to investigate the presence of NMDA-R, AMPA1-R, AMPA2-R, CASPR2, LGI1, GABAB-R, and GAD65 autoantibodies in a sample of Egyptian patients with new-onset DRE; also, to assess the clinical, cerebrospinal fluid (CSF), electroencephalogram (EEG), and radiological characteristics of those patients. Twenty-five patients with recent onset DRE were recruited from the department of Neurology at Ain Shams University (ASU) hospitals. All patients underwent serum and CSF antibody testing using cell-based assay (CBA) at the Immunology unit of the Clinical pathology laboratory at ASU hospitals. This is beside routine CSF analysis, EEG and MRI brain with contrast. Results Out of 25 patients with recent onset DRE, one (4%) patient tested positive to anti-NMDA-R antibodies and another one (4%) tested positive to anti-GAD 65 in both serum and CSF. Although the remaining 23 patients tested negative for the 7 autoantibodies, yet 92% of them achieved either seizure freedom or more than 50% reduction in the frequency of seizure and 84% had marked improvement in seizure-associated symptoms after receiving immunotherapy trial. Also, evidence of neuroinflammation was detected in the CSF and MRI brain of the majority of those patients. Conclusions Autoimmunity should be considered as a possible etiology of new-onset DRE. It is essential to provide insight into the clinical phenotypes and other associated features of those patients, as there are probably numerous patients who are not positive for one of the available antibodies via clinical laboratory testing. In addition to early diagnosis, early treatment and empirical immunotherapy trial based on the clinical judgment is crucial and is likely to improve outcomes with near-complete seizure freedom