Religious Concepts in Organ Transplantation

Beside cultural, social, and educational issues, religious beliefs are assumed to play a significant role on the attitude towards organ transplantation much more often than clinicians believe. At the same time, health-care providers may lack sufficient knowledge on religious issues pertaining to transplantation

Combination of Human Amniotic Fluid Derived-Mesenchymal Stem Cells and Nano-hydroxyapatite Scaffold Enhances Bone Regeneration

BACKGROUND: Human amniotic fluid-derived stem cells (hAF-MSCs) have a high proliferative capacity and osteogenic differentiation potential in vitro. The combination of hAF-MSCs with three-dimensional (3D) scaffold has a promising therapeutic potential in bone tissue engineering and regenerative medicine. Selection of an appropriate scaffold material has a crucial role in a cell supporting and osteoinductivity to induce new bone formation in vivo. AIM: This study aimed to investigate and evaluate the osteogenic potential of the 2nd-trimester hAF-MSCs in combination with the 3D scaffold, 30% Nano-hydroxyapatite chitosan, as a therapeutic application for bone healing in the induced tibia defect in the rabbit. SUBJECT AND METHODS: hAF-MSCs proliferation and culture expansion was done in vitro, and osteogenic differentiation characterisation was performed by Alizarin Red staining after 14 & 28 days. Expression of the surface markers of hAF-MSCs was assessed using Flow Cytometer with the following fluorescein-labelled antibodies: CD34-PE, CD73-APC, CD90-FITC, and HLA-DR-FITC. Ten rabbits were used as an animal model with an induced defect in the tibia to evaluate the therapeutic potential of osteogenic differentiation of hAF-MSCs seeded on 3D scaffold, 30% Nano-hydroxyapatite chitosan. The osteogenic differentiated hAF-MSCs/scaffold composite system applied and fitted in the defect region and non-seeded scaffold was used as control. The histopathological investigation was performed at 2, 3, & 4 weak post-transplantation and scanning electron microscope (SEM) was assessed at 2 & 4 weeks post-transplantation to evaluate the bone healing potential in the rabbit tibia defect. RESULTS: Culture and expansion of 2nd-trimester hAF-MSCs presented high proliferative and osteogenic potential in vitro. Histopathological examination for the transplanted hAF-MSCs seeded on the 3D scaffold, 30% Nano-hydroxyapatite chitosan, demonstrated new bone formation in the defect site at 2 & 3 weeks post-transplantation as compared to the control (non-seeded scaffold). Interestingly, the scaffold accelerated the osteogenic differentiation of AF-MSCs and showed complete bone healing of the defect site as compared to the control (non-seeded scaffold) at 4 weeks post-transplantation. Furthermore, the SEM analysis confirmed these findings. CONCLUSION: The combination of the 2nd-trimester hAF-MSCs and 3D scaffold, 30% Nano-hydroxyapatite chitosan, have a therapeutic perspective for large bone defect and could be used effectively in bone tissue engineering and regenerative medicine

Advances in Treatment of Hepatitis C and B

As in many areas of medicine, treatment of viral hepatitis has seen an acceleration of change driven by new therapies and evolving technology. Thanks to the direct-acting antiviral agents (DAAs), the era of HCV eradication and cure has begun. As regards to hepatitis B therapy, potent antiviral drugs for suppression of viral replication are available, new research activities to enhance eradication are visible, and these may influence clinical practice in the coming years. This book covers the latest advances in hepatitis C and hepatitis B therapeutics as well as the emerging and investigational treatment strategies. ""Advances in Treatment of Hepatitis C and Hepatitis B"" book is an up-to-date source of information for physicians, residents, and advanced medical students seeking a broader understanding of treatment of viral hepatitis. The authors of the chapters come from many eminent centers around the world and are experts in their respective fields

Spontaneous bacterial empyema in liver cirrhosis: An underdiagnosed pleural complication

Spontaneous bacterial empyema, defined as spontaneous infection of the pleural fluid, represents a distinct complication of hepatic hydrothorax with a different pathogenesis, clinical course and treatment strategy from those of empyema secondary to pneumonia. Nearly 40% of episodes of spontaneous empyema are not associated with spontaneous bacterial peritonitis (SBP) or even ascites. The condition portends a poor prognosis, and is frequently under-diagnosed. This article reviews the pathogenesis, diagnosis and management of spontaneous bacterial empyema

Assessment of hepatic steatosis of potential living donor before liver transplantation using liver/spleen CT attenuation ratio compared to liver biopsy

Abstract Background Hepatic steatosis has become a major worldwide health problem, so assessment of hepatic steatosis in potential living donors is crucial prior to liver transplantation. Until now liver biopsy (LB) is considered the gold standard for diagnosing steatosis before transplantation, however steatosis assessment using imaging modalities, such as computerized tomography (CT), would be better for the donor, due its non-invasiveness. This study aimed to assess the efficacy of CT as a semiquantitaive tool for liver steatosis assessment in liver donors in comparison to liver biopsy results. Methods This cross-sectional study was carried out on 53 potential liver graft donors. All patients were subjected to non-contrast CT of the abdomen, tru-cut liver biopsy, and histopathological evaluation. The CT liver attenuation (CTL), the hepatic/splenic CT attenuation ratio (CTL/S) and difference between hepatic attenuation value and splenic attenuation values (CTL–S) were determined as well as the correlations of these indices and the findings of Liver biopsy (LB) were compared. Results According to the hepatosteatosis grades in the pathology results, the patients were divided into two groups: group A: 38 patients with grade 0 hepatosteatosis and group B: 15 patients with grade 1 and 2 hepatosteatosis. CTL, CTL–S, CTL/S, ratio of mean right hepatic lobe and splenic attenuation (RT/S) and ratio of mean left hepatic lobe and splenic attenuation (LT/S) were found to be effective in the diagnosis of hepatosteatosis grades at cutoff values ≤ 55.4, ≤ 8.7, ≤ 1.17, ≤ 1.1548 and ≤ 1.2971 with 80%, 80%, 73.3%, 86.7% and 86.7% sensitivity and 71.1%, 56.8%, 73.7% 71.1% and 50.0% specificity respectively. Also, CTL/S was found to be very effective in the diagnosis of grade II hepatosteatosis at cutoff values ≤ 0.9 with 100% sensitivity and 100% specificity. There was significant negative correlations between the CT indexes and degree of hepatosteatosis. Conclusions Compared to biopsy results, CT noninvasive indices strongly predicted the presence of hepatosteatosis, which can help in avoiding the necessity for this invasive technique

Knowledge, Applicability, and Barriers of Telemedicine in Egypt: A National Survey

Objectives. The study is aimed at evaluating knowledge, attitude, and barriers to telemedicine among the general population in Egypt. Methods. A questionnaire-based cross-sectional design was carried out among the general Egyptian population. A convenience sampling method was used to approach the eligible participants from University Teaching Hospitals of eight governorates from May to July 2020. Results. A total of 686 participants filled the questionnaire (49.4% were males, mean age 36.7±11.2 years old). Half of the participants stated that they previously used a telemedicine tool, mainly to follow up laboratory results (67.3%). Video or phone calls (39.3%) and mobile applications (23.7%) were the most commonly recognized telemedicine tools by the participants. The included participants exhibited a high level of knowledge and attitude towards telemedicine. On the other hand, 21.9% stated that telemedicine services could jeopardize patient privacy. 32.8% reported that telemedicine service could lead to disclosing medical information to people who are not authorized to do so. Almost half of the participants agreed to strongly agreed that telemedicine service could increase medical errors. 60.80% of the participants said that they are more likely to prefer telemedicine than traditional ways. However, 13.70% stated that telemedicine is more likely to be challenging to use. Conclusion. The Egyptian population has high knowledge about the applications of telemedicine. In addition, the vast majority of Egyptians appear to perceive the benefits of telemedicine positively and are willing to use it. However, some barriers that have been found must be taken into consideration to adopt telemedicine successfully, especially for people who are old, are low educated, and live in remote areas. Future studies should address the utility of telemedicine in improving the quality of healthcare and patient’s health outcome and quality of life

Evaluation of Expressed MicroRNAs as Prospective Biomarkers for Detection of Breast Cancer

Background: Early detection and screening of breast cancer (BC) might help improve the prognosis of BC patients. This study evaluated the use of serum microRNAs (miRs) as non-invasive biomarkers in BC patients. Methods: Using quantitative real-time polymerase chain reaction, we evaluated the serum expression of four candidate miRs (miR-155, miR-373, miR-10b, and miR-34a) in 99 Egyptian BC patients and 40 healthy subjects (as a control). The miRs expression was correlated with clinicopathological data. In addition, the sensitivity and specificity of the miRs were determined using receiver operating characteristic (ROC) curve analysis. Results: Serum miR-155, miR-373, and miR-10b expression were significantly upregulated (p < 0.001), while serum miR-34a was downregulated (p < 0.00) in nonmetastatic (M0) BC patients compared to the control group. In addition, serum miR-155 and miR-10b were upregulated in BC patients with large tumor sizes and extensive nodal involvement (p < 0.001). ROC curve analysis showed high diagnostic accuracy (area under the curve = 1.0) when the four miRs were combined. Serum miR-373 was significantly upregulated in the human epidermal growth factor 2–negative (p < 0.001), estrogen receptor–positive (p < 0.005), and progesterone receptor (PR)-positive (p < 0.024) in BC patients, and serum miR-155 was significantly upregulated in PR-negative (p < 0.001) BC patients while both serum miR-155 and miR-373 were positively correlated with the tumor grade. Conclusions: Circulating serum miR-155, miR-373, miR-10b, and miR-34a are potential biomarkers for early BC detection in Egyptian patients and their combination shows high sensitivity and specificity