30 research outputs found

    Effect of intensive phototherapy on T and B lymphocyte function in neonatal jaundice

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    Background: Jaundice is one of the most common problems that affect newborns in the first few days of life. Approximately 60% of full-term and 80% of the preterm newborn may develop neonatal jaundice. Although neonatal jaundice is of physiological type in most of these cases, some cases may have elevated serum bilirubin levels which, if not treated, may lead to bilirubin encephalopathy and subsequently bilirubin induced neurological dysfunction (BIND). Objective: This study aimed to evaluate the effect of intensive phototherapy on B and T cells by measuring the percentages of CD19+, CD4+ and CD8+ lymphocytes subsets in newborns after 72 hours from exposure to intensive phototherapy to evaluate its effect on the immune system.Patients and methods: A prospective cohort study carried out in Zagazig University Hospital, Pediatric Neonatal Intensive Care Unit (NICU) and Clinical Pathology Departments. The study included 50 full-term newborns. Results: There was no significant difference regarding CD4, CD8 and CD19 for the patient group. Furthermore, the study showed that the percentages of CD4+ and CD8+ lymphocytes subsets showed no change in newborns after 72 hours of exposure to phototherapy, but CD19+ was highly significantly lower before treatment only. In addition, the follow up of those 25 jaundiced newborns for occurrence and frequency of infection and need for hospitalization for a period of six months after discharge showed no effect.Conclusion: our results showed no effect of phototherapy on lymphocyte subsets after 72 hours of exposure and no effect on infant immunity

    Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

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    Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P < 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely

    IL-28B genetic polymorphism as a Predictor for Efficacy of Treatment with Interferon in Egyptian Hepatitis C Patients

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    ABSTRACT Hepatitis C is a global health problem and represents a major cause of liver disease and socioeconomic burden. Effective antiviral therapy may prevent these complications, but the current treatment for patients with chronic hepatitis C virus (HCV) infection does not achieve sustained virological response (SVR) for all patients. Therefore, identification of the determinants of response to treatment is a high priority. A number of host and viral factors have been associated with treatment outcomes. Genome-wide association studies implicated IL28B single-nucleotide polymorphisms (SNPs) as the strongest genetic pretreatment predictor of SVR in HCV infection. Recently, the American Association for the Study of Liver Diseases and the European Association for the Study of the Liver included IL28B testing in their guidelines.The present study was aimed toinvestigate the possible role of the SNPs of IL-28B(rs12980275 and rs8099917) inpredicting the response to therapy in Egyptian patients infected with hepatitis C virus-4 (HCV-4).Egyptian patients were treated with Peg-IFN-α/RBV. A total of 200 HCV-4 infected patients and 100 healthy control subjects were included in the presentstudy.SNPs in the IL-28B (rs8099917 T/G andrs12980275A/G) geneswere assessed usinga simple, rapid, and inexpensive polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method.The IL28B rs8099917 TT and rs12980275 AA genotypes were significantly higher in responders than in nonresponder (P=0.011 and P=0.012, respectively). Significant association between IL-rs8099917 TT and rs8099975AA was observed in responder group (P=0.0152). No significant differences in genotype and allele frequencies of IL28B gene (rs8099917 and rs12980275) between males and females were observed (P> 0.05). It can be concluded that SNPs in IL-28B may be promising predictors of SVR inHCV-4 infection

    NRF2 and P73 polymorphisms in Egyptian women with breast cancer

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    The aim of the study was to assess the role of Nrf2 promoter and P73 G4C14 to A4T14 polymorphisms in  breast cancer and the potential relation to the onset of the disease. Eighty six female patients with breast tumor were included in this study. Nrf2 (rs6721961) and p73 (G4A) genetic polymorphisms in promoter  and exon2 region respectively were investigated using PCR-CTPP assay. The genotype frequencies of the three genotypes of Nrf2 promoter SNP (CC, CA, AA) showed no significant difference between benign and malignant  groups. Genotype frequencies for P73 G4A SNP (GG, GA) showed no significant difference between benign and malignant groups, no patient have the AA genotype. Regarding the onset of disease, the three Nrf2 genotypes in pre - and post-menopausal patients, showed that the distribution differ significantly in the 2 patients groups and that the AA genotype is significantly higher in the pre-menopausal patients compared to post-menopausal patients. Nrf2 (rs6721961) AA genotype might be related to early breast cancer onset. P73 G4A polymorphism shows no relation to both disease risk and disease onset. Therefore Nrf2 (rs6721961) promoter genotyping  might be related to the risk of pre-menopausal breast cancer.Key words: Breast cancer, Polymorphisms, Nrf2, P7
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