Angiogenic biomarkers in children with congenital heart disease: possible implications

<p>Abstract</p> <p>Background</p> <p>Vascular endothelial growth factor (VEGF), platelet derived endothelial cell growth factor/thymidine phosphorylase (PD-ECGF/TP) and leptin are known as potent angiogenic factors The objective of the study was to evaluate these angiogenic factors VEGF, PD-ECGF/TP and leptin in children with congenital heart disease (CHD) and the factors that lead to angiogenesis in such cases.</p> <p>Methods</p> <p>Sixty CHD children were studied and divided into two groups (n = 30); cyanotic-CHD (C-CHD) and acyanotic-CHD (A-CHD). Twenty five healthy children were included as controls.</p> <p>Results</p> <p>Significantly higher serum levels of VEGF, PD-ECGF/TP activity and leptin were detected in patients with CHD, particularly in patients with C-CHD. CHD patients with SpO₂<90%, pulmonary hypertension (PH), severe pulmonary stenosis (PS), detectable collaterals, cardiomegaly and/or heart failure showed significantly higher levels of these factors than those with higher SpO₂or those without these findings.</p> <p>Conclusion</p> <p>Hypoxia, PH and PS are important factors that lead to harmful angiogenesis. However, angiogenesis could be essential in some cases of CHD as coarctation of aorta to enhance renal perfusion. This may provide new ways for therapeutic strategies aiming at reducing or promoting angiogenesis in CHD to improve patient's outcome.</p

A PDE Method to Segment Image Linear Objects with Application to Lens Distortion Removal

In this paper, we propose a partial differential equation based method to segment image objects, which have a given parametric shape based on energy functional. The energy functional is composed of a term that detects object boundaries and a term that constrains the contour to find a shape compatible with the parametric shape. While the shape constraints guiding the PDE may be determined from object's shape statistical models, we demonstrate the proposed approach on the extraction of objects with explicit shape parameterization, such as linear image segments. Several experiments are reported on synthetic and real images to evaluate our approach. We also demonstrate the successful application of the proposed method to the problem of removing camera lens distortion, which can be significant in medium to wide-angle lenses

Effects of Anesthetic Management on Inflammatory Markers in Patients After Major Abdominal Surgeries: A Double-Blind Controlled Study

Background: Surgical trauma induces systemic inflammatory responses. We aimed to evaluate the influence of different analgesic models on postoperative pain and inflammatory markers modulation after major abdominal surgeries. Materials and Methods: A total of 105 patients scheduled for elective abdominal colorectal surgeries were selected and randomly assigned to one of the three groups: Group-1 (GM) four micrograms/kg of IT morphine; Group-2 (GML) four microgram/kg of IT morphine plus 1.5 mg/kg intravenous Lidocaine loading dose and 2 mg/min saline infusion during the operation and the next 4 hours postoperative; Group-3 (G0, control group) no added drugs. Results: Pain scored statistically significant lower figures in GML than the other two groups; p&lt;0.001. Tumor Necrosis Factor-alpha serum levels showed a statistically significant difference between the three groups; P &lt;0.001; GML showed the lowest level, followed by group GM and Group 0 (10.3±4.4 vs. 20±4.4 vs. 26±7.5). Transforming Growth Factor beta-1 demonstrated the highest levels measured in GML, high levels in GM, and the lowest level in G0; p&lt;0.001, where mean serum levels were 43.1±12.5, 26 ±4.2, and 18.9±7.7, respectively. Opioid consumption was significantly lower in GML than other two groups; P&lt;0.001. Conclusion: Intraoperative and early postoperative intravenous Lidocaine infusion significantly improved the quality of postoperative analgesia. Optimizing analgesia in anesthetic management has a favorable effect on the pro and anti-inflammatory mediators. Keywords: Abdominal surgeries, Postoperative pain, TNF-alpha and TGF-bet

Removal of Cd2+ from aqueous solution by zeolite synthesized from Egyptian kaolin

Zeolite Na-Y was prepared from kaolin located in Wadi-Hagul, Suez, Egypt. The synthetic zeolite prepared by the hydrothermal reaction of kaolin was characterized by X-ray fluorescence (XRF), X-ray diffraction (XRD), scanning electron microscopy (SEM) and cation exchange capacity (CEC). Cadmium ion removal was investigated using the synthetic solution of Cd2+ ions with different concentrations at room temperature (25 °C ± 0.2), initial pH of the solution and contact times. The optimum contact time for removal of Cd2+ ion was 10 min, with 0.1g of synthetic zeolite and pH 7.57. The experimental data were correlated using Langmuir, Freundlich and Harkins-Jura adsorption isotherms. The maximum adsorption capacity Qm obtained from the Langmuir isotherm was 14.006 mg/g for Cd2+ ion. Kinetic studies reveal that synthetic zeolite is more effective as adsorbent for removing cadmium ion

Vitamin D level in preschool children with recurrent wheezy chest, and its relation to the severity of the wheezing episodes

Background: Recurrent wheezy chest is a common complaint in pediatric practice. Vitamin D is a potent immunomodulator in allergic diseases as wheezy chest and asthma. The prevalence of vitamin D deficiency has been increasing in Egypt leading to significant morbidities.Objectives: This study aimed to assess serum 25 hydroxy (OH) Vitamin D level in preschool children with recurrent wheezy chest, and to assess its relation to the recurrence, severity, and level of control of the wheezing episodes.Methods: The study included 100 preschool children (aged 2 to 5 years), of both sexes, recruited from the Emergency department, Allergy and Pulmonology units at Assiut University Children Hospital, Egypt. They should have at least 3 documented episodes of wheeze, cough, and difficulty breathing in the last year with clinical improvement on inhaled short-acting beta 2 agonists. Patients were subjected to questionnaire-based history, clinical examination, and laboratory investigations (complete blood count (CBC) with the absolute eosinophil count, serum total IgE level, and serum 25 hydroxy (OH) Vitamin D level). Pediatric Respiratory Assessment Measure (PRAM score) for assessment of the severity of the wheezing episodes and Global Initiative for Asthma (GINA) based level of asthma control for children 5 years and younger were applied. The patients were grouped according to PRAM score to mild, moderate and severe episodes and according to vitamin D level as sufficient and below-sufficient groups (including deficient and insufficient patients).Results: 25(OH) Vitamin D level was below-sufficient in 53% of the studied patients (deficient in 32% and insufficient in 21%). PRAM score was significantly lower in patients with sufficient 25(OH) Vitamin D level versus those with below-sufficient level (p &lt; 0.025). There was a significant negative correlation between PRAM score and 25 (OH) Vitamin D level (r = -0.334, p = 0.001).Conclusion: There is an inverse relationship between 25(OH)vitamin D level and parameters of asthma severity, as well as with the level of asthma control in preschool children with recurrent wheezy chest.Keywords: Vitamin D, recurrent wheezy chest, preschool childre

COVID-19 and myocarditis: a brief review

Cardiovascular complications (especially myocarditis) related to COVID-19 viral infection are not well understood, nor do they possess a well recognized diagnostic protocol as most of our information regarding this issue was derived from case reports. In this article we extract data from all published case reports in the second half of 2020 to summarize the theories of pathogenesis and explore the value of each diagnostic test including clinical, lab, ECG, ECHO, cardiac MRI and endomyocardial biopsy. These tests provide information that explain the mechanism of development of myocarditis that further paves the way for better management

Enhanced oral permeability of Trans-Resveratrol using nanocochleates for boosting anticancer efficacy; in-vitro and ex-vivo appraisal

Hepatocellular carcinoma (HCC) is a prevalent liver cancer representing the fourth most lethal cancer worldwide. Trans-Resveratrol (T-R) possesses a promising anticancer activity against HCC. However, it suffers from poor bioavailability because of the low solubility, chemical instability, and hepatic metabolism. Herein, we developed T-R-loaded nanocochleates using a simple trapping method. Nanocarriers were optimized using a comprehensive in-vitro characterization toolset and evaluated for the anticancer activity against HepG2 cell line. T-R-loaded nanocochleates demonstrated monodispersed cylinders (163.27 ± 2.68 nm and 0.25 ± 0.011 PDI) and −46.6 mV ζ-potential. They exhibited a controlled biphasic pattern with minimal burst followed by sustained release for 72 h. Significant enhancements of Caco-2 transport and ex-vivo intestinal permeation over liposomes, with 1.8 and 2.1-folds respectively, were observed. Nanocochleates showed significant reduction of 24 h IC50 values compared to liposomes and free T-R. Moreover, an efficient knockdown of anti-apoptotic (Bcl-2) and cancer stemness (NANOG) genes was demonstrated. To the best of our knowledge, we are the first to develop T-R loaded nanocochleates and scrutinize its potential in suppressing NANOG expression, 2-folds lower, compared to free T-R. According to these auspicious outcomes, nanocochleates represent a promising nanoplatform to enhance T-R oral permeability and augment its anticancer efficacy in the treatment of HCC

May Coronary Artery Bypass Grafting Affect Native Coronary Atherosclerosis progression?

Background: Coronary artery bypass grafting (CABG) continues to be the best standard in the management of severe coronary artery disease (CAD), providing good symptom management and life extension. Although CABG was first performed by reversed saphenous veins (SVGs), surgeons have increasingly adopted arterial conduits because of their longer-term patency and resistance to atherosclerosis. CABG's efficacy may potentially be affected by the extension of atherosclerosis in the native coronary arteries. Few researches have investigated the long-term angiographic disease progression of native coronary arteries after surgical revascularization, or the variables that may impact this progression. Proximal native disease progression was presented to be two to six times more common than distal disease progression, with greater rates of progression in coronaries bypassed by SVGs than arterial grafts. The goal of this research was to determine influence of CABG on the extension of native coronaries atherosclerosis. Methods: This prospective study was established on 25 patients who were diagnosed to have ischemic heart disease in cardiothoracic surgery department in Faculty of Medicine Menoufia University. Results: The study showed that according to the risk factors among the studied cases, smoking was (60%), Dyslipidemia was (32%), HTN was (32%) and Diabetes was (32). According to grafts in proximal lesions, there was progression of atherosclerosis up to total occlusion, but in Distal lesions, there was significant regression of atherosclerosis. As result, there was statistically significant difference between proximal with distal lesions. Also, study showed that there was a significant difference between left system (LAD, D, OM) in comparison with right system (PDA) regarding distal lesion. Our results showed that univariate logistic regression analysis for progression in distal lesion regarding Dyslipidemia and Diabetes. Conclusion: Progression of disease is more evident in coronary segment proximal to anastomosis, while regression of disease is more evident in coronary segment distal to anastomosis with statistically significant difference between them, also the risk of disease progression post CABG was found to be multifactorial, as certain risk factors can affect progression of the disease as Diabetes mellitus and dyslipidemia that were of statistically significance

The Role of 3D CT Imaging in the Accurate Diagnosis of Lung Function in Coronavirus Patients

Early grading of coronavirus disease 2019 (COVID-19), as well as ventilator support machines, are prime ways to help the world fight this virus and reduce the mortality rate. To reduce the burden on physicians, we developed an automatic Computer-Aided Diagnostic (CAD) system to grade COVID-19 from Computed Tomography (CT) images. This system segments the lung region from chest CT scans using an unsupervised approach based on an appearance model, followed by 3D rotation invariant Markov–Gibbs Random Field (MGRF)-based morphological constraints. This system analyzes the segmented lung and generates precise, analytical imaging markers by estimating the MGRF-based analytical potentials. Three Gibbs energy markers were extracted from each CT scan by tuning the MGRF parameters on each lesion separately. The latter were healthy/mild, moderate, and severe lesions. To represent these markers more reliably, a Cumulative Distribution Function (CDF) was generated, then statistical markers were extracted from it, namely, 10th through 90th CDF percentiles with 10% increments. Subsequently, the three extracted markers were combined together and fed into a backpropagation neural network to make the diagnosis. The developed system was assessed on 76 COVID-19-infected patients using two metrics, namely, accuracy and Kappa. In this paper, the proposed system was trained and tested by three approaches. In the first approach, the MGRF model was trained and tested on the lungs. This approach achieved 95.83% accuracy and 93.39% kappa. In the second approach, we trained the MGRF model on the lesions and tested it on the lungs. This approach achieved 91.67% accuracy and 86.67% kappa. Finally, we trained and tested the MGRF model on lesions. It achieved 100% accuracy and 100% kappa. The results reported in this paper show the ability of the developed system to accurately grade COVID-19 lesions compared to other machine learning classifiers, such as k-Nearest Neighbor (KNN), decision tree, naïve Bayes, and random forest

Early assessment of lung function in coronavirus patients using invariant markers from chest X-rays images

The primary goal of this manuscript is to develop a computer assisted diagnostic (CAD) system to assess pulmonary function and risk of mortality in patients with coronavirus disease 2019 (COVID-19). The CAD system processes chest X-ray data and provides accurate, objective imaging markers to assist in the determination of patients with a higher risk of death and thus are more likely to require mechanical ventilation and/or more intensive clinical care.To obtain an accurate stochastic model that has the ability to detect the severity of lung infection, we develop a second-order Markov-Gibbs random field (MGRF) invariant under rigid transformation (translation or rotation of the image) as well as scale (i.e., pixel size). The parameters of the MGRF model are learned automatically, given a training set of X-ray images with affected lung regions labeled. An X-ray input to the system undergoes pre-processing to correct for non-uniformity of illumination and to delimit the boundary of the lung, using either a fully-automated segmentation routine or manual delineation provided by the radiologist, prior to the diagnosis. The steps of the proposed methodology are: (i) estimate the Gibbs energy at several different radii to describe the inhomogeneity in lung infection; (ii) compute the cumulative distribution function (CDF) as a new representation to describe the local inhomogeneity in the infected region of lung; and (iii) input the CDFs to a new neural network-based fusion system to determine whether the severity of lung infection is low or high. This approach is tested on 200 clinical X-rays from 200 COVID-19 positive patients, 100 of whom died and 100 who recovered using multiple training/testing processes including leave-one-subject-out (LOSO), tenfold, fourfold, and twofold cross-validation tests. The Gibbs energy for lung pathology was estimated at three concentric rings of increasing radii. The accuracy and Dice similarity coefficient (DSC) of the system steadily improved as the radius increased. The overall CAD system combined the estimated Gibbs energy information from all radii and achieved a sensitivity, specificity, accuracy, and DSC of 100%, 97% ± 3%, 98% ± 2%, and 98% ± 2%, respectively, by twofold cross validation. Alternative classification algorithms, including support vector machine, random forest, naive Bayes classifier, K-nearest neighbors, and decision trees all produced inferior results compared to the proposed neural network used in this CAD system. The experiments demonstrate the feasibility of the proposed system as a novel tool to objectively assess disease severity and predict mortality in COVID-19 patients. The proposed tool can assist physicians to determine which patients might require more intensive clinical care, such a mechanical respiratory support