Serum amino acid abnormalities in pediatric patients with chronic renal failure with and without history of thromboembolic manifestations

Background: Plasma amino acid concentrations have been reported to be abnormal in patients with chronic renal failure. L-Arginine has been used to improve endothelial function by increasing nitric oxide (NO) bioavailability. The present study aim at investigating the status of plasma amino acids in pediatric patients with chronic renal failure (CRF) on regular hemodialysis (HD) with and without history of thromboembolic manifestations.Methods: The study included 21 hemodialysis patients subdivided into two groups (those with no history of thromboembolic manifestations and those with positive history of thromboembolic manifestations) The control group included 13 age and sex matched apparently healthy subjects, After careful history taking, clinical examination, the following laboratory investigations were performed: serum calcium, phosphate, albumin, and creatinine (for controls only), complete blood count (CBC) and serum amino acid analysis.Results: HD patients had a significantly lower concentration of threonine, valine, methionine, leucine, tyrosine, phenylalanine and tryptophane than the control group (p= 0.032, 0.020, 0.046, 0.011, 0.000, 0.022, and 0.004 respectively). There was no significant difference between HD patients and the control group as regard aspartic acid, serine, asparagine, glutamic acid, proline, glycine, alanine, cystine, isoleucine, lysine, histidine, and arginine. The mean serum L-arginine level was lower in 61.9% of HD patients than the mean of the controls with no significant difference. L-Arginine concentration was not significantly different between HD patients with and without history of thromboembolic manifestations.Conclusion: Several abnormalities in amino acids were present in HD patients compared to controls. The mean serum L-arginine level was lower in 61.9% of HD patients than the mean of the controls with no significant difference. L-Arginine concentration was not significantly different between HD patients with and without history of thromboembolic manifestations. HD patients without history of thromboembolic manifestations had significantly lower glutamic acid concentrations and significantly higher phenylalanine concentrations than HD patients with history of thromboembolic manifestations.Keywords: Serum amino acid; Chronic renal failure; L-Arginin

Assessment of using Aloe vera gel alone and in combination with lemongrass essential oil as coating materials for strawberry fruits: HPLC and EDX analyses

This is the final version. Available on open access from MDPI via the DOI in this record. Strawberry is a non-climacteric fruit but exhibits a limited postharvest life due to rapid softening and decay. A strawberry coating that is natural and safe for human consumption can be used to improve the appearance and safeguard the fruits. In this study, 20% and 40% Aloe vera gel alone or in combination with 1% lemongrass essential oil (EO) was used as an edible coating for strawberries. After application of all the treatments, the strawberry fruits were stored at a temperature of 5 ± 1 ◦C at a relative humidity (RH) of 90%–95% for up to 16 days and all the parameters were analyzed and compared to control (uncoated fruits). The results show that A. vera gel alone or with lemongrass EO reduced the deterioration and increased the shelf life of the fruit. Treatment with A. vera gel and lemongrass EO decreased acidity and total anthocyanins and maintained fruit firmness. Treatment with A. vera gel 40% + lemongrass EO 1% led to the lowest weight loss, retained firmness and acidity, but increased the total soluble solids and total anthocyanins compared to uncoated fruits during storage of up to 16 days. The phenolic compounds of A. vera gel were analyzed by HPLC, and the most abundant compounds were found to be caffeic (30.77 mg/mL), coumaric (22.4 mg/mL), syringic (15.12 mg/mL), sinapic (14.05 mg/mL), ferulic (8.22 mg/mL), and cinnamic acids (7.14 mg/mL). Lemongrass EO was analyzed by GC–MS, and the most abundant compounds were identified as α-citral (neral) (40.10%) β-citral (geranial) (30.71%), γ-dodecalactone (10.24%), isoneral (6.67%), neryl acetal (5.64%), and linalool (1.77%). When the fruits were treated with 20% or 40% A. vera gel along with 1% lemongrass, their total phenolic content was maintained during the storage period (from 4 to 8 days). The antioxidant activity was relatively stable during the 8 days of cold storage of the fruits coated with A. vera gel combined with lemongrass EO because the activity of both 20% and 40% gel was greater than that for the other treatments after 12 days of storage in both experiments. Moreover, all the treatments resulted in lower numbers of total microbes at the end of the storage period compared with the control treatment. This study indicates that the use of Aloe vera gel with lemongrass EO as an edible coating considerably enhances the productivity of strawberry fruits and the treatment could be used on a commercial scaleKing Saud University, Riyadh, Saudi Arabia

Post-Harvest Enhancing and Botrytis cinerea Control of Strawberry Fruits Using Low Cost and Eco-Friendly Natural Oils

This is the final version. Available from MDPI via the DOI in this record.This work investigates an experimental study for using low-cost and eco-friendly oils to increase the shelf life of strawberry fruit. Three natural oils were used: (i) Eucalyptus camaldulensis var obtuse, (ii) Mentha piperita green aerial parts essential oils (EOs), and (iii) Moringa oleifera seeds n-hexane fixed oil (FO). Furthermore, a mixture of EOs from E. camaldulensis var obtusa and M. piperita (1/1 v/v) was used. The treated fruits were stored at 5 °C and 90% relative humidity (RH) for 18 days. HPLC was used to analyse the changes in phenolic compounds during the storage periods. The effects of biofumigation through a slow-release diffuser of EOs (E. camaldulensis var obtusa and M. piperita), or by coating with M. oleifera FO, were evaluated in terms of control of post-harvest visual and chemical quality of strawberry fruits. The post-harvest resistance of strawberry fruits to Botrytis cinerea fungal infection was also evaluated. As a result, the EO treatments significantly reduced the change in visual and chemical quality of strawberry fruit. Additionally, changes in the titratable acidity of moringa FO-coated strawberry fruits were delayed. EO treatments improved total soluble solids, total phenols, ascorbic acid, antioxidants and peroxidase. E. camaldulensis var obtusa and M. piperita (1/1 v/v) EO-vapour fruit exhibited a slower rate of deterioration, compared to other treatments in all tested, in two experiments. The lowest colour change (ΔE) was observed inthe fruit treated with E. camaldulensis var obtusa EO and M. oleifera FO. HPLC showed changes in phenolic compounds’ concentration, where p-coumaric acid, caffeic acid, gallic acid, ferulic acid and ellagic acid were mostly identified in the fruits treated with the oils. SEM examination confirmed the potential decrease in fungal growth as the fruits were treated with EOs. In conclusion, the treatment of EOs during different storage periods showed promising characterisations for strawberry fruit quality.Deanship of Scientific Research, King Saud Universit

Molecular identification of adenoviruses associated with respiratory infection in Egypt from 2003 to 2010.

BACKGROUND: Human adenoviruses of species B, C, and E (HAdV-B, -C, -E) are frequent causative agents of acute respiratory infections worldwide. As part of a surveillance program aimed at identifying the etiology of influenza-like illness (ILI) in Egypt, we characterized 105 adenovirus isolates from clinical samples collected between 2003 and 2010. METHODS: Identification of the isolates as HAdV was accomplished by an immunofluorescence assay (IFA) and confirmed by a set of species and type specific polymerase chain reactions (PCR). RESULTS: Of the 105 isolates, 42% were identified as belonging to HAdV-B, 60% as HAdV-C, and 1% as HAdV-E. We identified a total of six co-infections by PCR, of which five were HAdV-B/HAdV-C co-infections, and one was a co-infection of two HAdV-C types: HAdV-5/HAdV-6. Molecular typing by PCR enabled the identification of eight genotypes of human adenoviruses; HAdV-3 (n = 22), HAdV-7 (n = 14), HAdV-11 (n = 8), HAdV-1 (n = 22), HAdV-2 (20), HAdV-5 (n = 15), HAdV-6 (n = 3) and HAdV-4 (n = 1). The most abundant species in the characterized collection of isolates was HAdV-C, which is concordant with existing data for worldwide epidemiology of HAdV respiratory infections. CONCLUSIONS: We identified three species, HAdV-B, -C and -E, among patients with ILI over the course of 7 years in Egypt, with at least eight diverse types circulating

Vaccination Targeting a Surface Sialidase of P. acnes: Implication for New Treatment of Acne Vulgaris

BACKGROUND: Acne vulgaris afflicts more than fifty million people in the United State and the severity of this disorder is associated with the immune response to Propionibacterium acnes (P. acnes). Systemic therapies for acne target P. acnes using antibiotics, or target the follicle with retinoids such as isotretinoin. The latter systemic treatment is highly effective but also carries a risk of side effects including immune imbalance, hyperlipidemia, and teratogenicity. Despite substantial research into potential new therapies for this common disease, vaccines against acne vulgaris are not yet available. METHODS AND FINDINGS: Here we create an acne vaccine targeting a cell wall-anchored sialidase of P. acnes. The importance of sialidase to disease pathogenesis is shown by treatment of a human sebocyte cell line with recombinant sialidase that increased susceptibility to P. acnes cytotoxicity and adhesion. Mice immunized with sialidase elicit a detectable antibody; the anti-sialidase serum effectively neutralized the cytotoxicity of P. acnes in vitro and P. acnes-induced interleukin-8 (IL-8) production in human sebocytes. Furthermore, the sialidase-immunized mice provided protective immunity against P. acnes in vivo as this treatment blocked an increase in ear thickness and release of pro-inflammatory macrophage inflammatory protein (MIP-2) cytokine. CONCLUSIONS: Results indicated that acne vaccines open novel therapeutic avenues for acne vulgaris and other P. acnes-associated diseases

Global, regional, and national comparative risk assessment of 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks, 1990-2015: a systematic analysis for the Global Burden of Disease Study 2015

SummaryBackground The Global Burden of Diseases, Injuries, and Risk Factors Study 2015 provides an up-to-date synthesis of the evidence for risk factor exposure and the attributable burden of disease. By providing national and subnational assessments spanning the past 25 years, this study can inform debates on the importance of addressing risks in context. Methods We used the comparative risk assessment framework developed for previous iterations of the Global Burden of Disease Study to estimate attributable deaths, disability-adjusted life-years (DALYs), and trends in exposure by age group, sex, year, and geography for 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks from 1990 to 2015. This study included 388 risk-outcome pairs that met World Cancer Research Fund-defined criteria for convincing or probable evidence. We extracted relative risk and exposure estimates from randomised controlled trials, cohorts, pooled cohorts, household surveys, census data, satellite data, and other sources. We used statistical models to pool data, adjust for bias, and incorporate covariates. We developed a metric that allows comparisons of exposure across risk factors—the summary exposure value. Using the counterfactual scenario of theoretical minimum risk level, we estimated the portion of deaths and DALYs that could be attributed to a given risk. We decomposed trends in attributable burden into contributions from population growth, population age structure, risk exposure, and risk-deleted cause-specific DALY rates. We characterised risk exposure in relation to a Socio-demographic Index (SDI). Findings Between 1990 and 2015, global exposure to unsafe sanitation, household air pollution, childhood underweight, childhood stunting, and smoking each decreased by more than 25%. Global exposure for several occupational risks, high body-mass index (BMI), and drug use increased by more than 25% over the same period. All risks jointly evaluated in 2015 accounted for 57·8% (95% CI 56·6–58·8) of global deaths and 41·2% (39·8–42·8) of DALYs. In 2015, the ten largest contributors to global DALYs among Level 3 risks were high systolic blood pressure (211·8 million [192·7 million to 231·1 million] global DALYs), smoking (148·6 million [134·2 million to 163·1 million]), high fasting plasma glucose (143·1 million [125·1 million to 163·5 million]), high BMI (120·1 million [83·8 million to 158·4 million]), childhood undernutrition (113·3 million [103·9 million to 123·4 million]), ambient particulate matter (103·1 million [90·8 million to 115·1 million]), high total cholesterol (88·7 million [74·6 million to 105·7 million]), household air pollution (85·6 million [66·7 million to 106·1 million]), alcohol use (85·0 million [77·2 million to 93·0 million]), and diets high in sodium (83·0 million [49·3 million to 127·5 million]). From 1990 to 2015, attributable DALYs declined for micronutrient deficiencies, childhood undernutrition, unsafe sanitation and water, and household air pollution; reductions in risk-deleted DALY rates rather than reductions in exposure drove these declines. Rising exposure contributed to notable increases in attributable DALYs from high BMI, high fasting plasma glucose, occupational carcinogens, and drug use. Environmental risks and childhood undernutrition declined steadily with SDI; low physical activity, high BMI, and high fasting plasma glucose increased with SDI. In 119 countries, metabolic risks, such as high BMI and fasting plasma glucose, contributed the most attributable DALYs in 2015. Regionally, smoking still ranked among the leading five risk factors for attributable DALYs in 109 countries; childhood underweight and unsafe sex remained primary drivers of early death and disability in much of sub-Saharan Africa. Interpretation Declines in some key environmental risks have contributed to declines in critical infectious diseases. Some risks appear to be invariant to SDI. Increasing risks, including high BMI, high fasting plasma glucose, drug use, and some occupational exposures, contribute to rising burden from some conditions, but also provide opportunities for intervention. Some highly preventable risks, such as smoking, remain major causes of attributable DALYs, even as exposure is declining. Public policy makers need to pay attention to the risks that are increasingly major contributors to global burden. Funding Bill & Melinda Gates Foundation

Smoking prevalence and attributable disease burden in 195 countries and territories, 1990-2015 : a systematic analysis from the Global Burden of Disease Study 2015

Background The scale-up of tobacco control, especially after the adoption of the Framework Convention for Tobacco Control, is a major public health success story. Nonetheless, smoking remains a leading risk for early death and disability worldwide, and therefore continues to require sustained political commitment. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) offers a robust platform through which global, regional, and national progress toward achieving smoking-related targets can be assessed. Methods We synthesised 2818 data sources with spatiotemporal Gaussian process regression and produced estimates of daily smoking prevalence by sex, age group, and year for 195 countries and territories from 1990 to 2015. We analysed 38 risk-outcome pairs to generate estimates of smoking-attributable mortality and disease burden, as measured by disability-adjusted life-years (DALYs). We then performed a cohort analysis of smoking prevalence by birth-year cohort to better understand temporal age patterns in smoking. We also did a decomposition analysis, in which we parsed out changes in all-cause smoking-attributable DALYs due to changes in population growth, population ageing, smoking prevalence, and risk-deleted DALY rates. Finally, we explored results by level of development using the Socio-demographic Index (SDI). Findings Worldwide, the age-standardised prevalence of daily smoking was 25.0% (95% uncertainty interval [UI] 24.2-25.7) for men and 5.4% (5.1-5.7) for women, representing 28.4% (25.8-31.1) and 34.4% (29.4-38.6) reductions, respectively, since 1990. A greater percentage of countries and territories achieved significant annualised rates of decline in smoking prevalence from 1990 to 2005 than in between 2005 and 2015; however, only four countries had significant annualised increases in smoking prevalence between 2005 and 2015 (Congo [Brazzaville] and Azerbaijan for men and Kuwait and Timor-Leste for women). In 2015, 11.5% of global deaths (6.4 million [95% UI 5.7-7.0 million]) were attributable to smoking worldwide, of which 52.2% took place in four countries (China, India, the USA, and Russia). Smoking was ranked among the five leading risk factors by DALYs in 109 countries and territories in 2015, rising from 88 geographies in 1990. In terms of birth cohorts, male smoking prevalence followed similar age patterns across levels of SDI, whereas much more heterogeneity was found in age patterns for female smokers by level of development. While smoking prevalence and risk-deleted DALY rates mostly decreased by sex and SDI quintile, population growth, population ageing, or a combination of both, drove rises in overall smoking-attributable DALYs in low-SDI to middle-SDI geographies between 2005 and 2015. Interpretation The pace of progress in reducing smoking prevalence has been heterogeneous across geographies, development status, and sex, and as highlighted by more recent trends, maintaining past rates of decline should not be taken for granted, especially in women and in low-SDI to middle-SDI countries. Beyond the effect of the tobacco industry and societal mores, a crucial challenge facing tobacco control initiatives is that demographic forces are poised to heighten smoking's global toll, unless progress in preventing initiation and promoting cessation can be substantially accelerated. Greater success in tobacco control is possible but requires effective, comprehensive, and adequately implemented and enforced policies, which might in turn require global and national levels of political commitment beyond what has been achieved during the past 25 years.Peer reviewe

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