Hepatic Arterial Therapy with Drug-Eluting Beads in the Management of Metastatic Bronchogenic Carcinoma to the Liver: A Multi-Institutional Registry

Introduction. There has been limited information reported on the use of hepatic arterial therapy in liver dominant hepatic metastases arising from lung cancer. The aim of this study was to evaluate the safety and efficacy of hepatic arterial therapy in the treatment of liver dominant hepatic metastases arising from lung cancer. Methods. Thirteen patients underwent a total of 30 treatment sessions with Drug-Eluting Beads. Eight of the thirteen received only doxorubicin DEB (17 of the total treatments), and four patients received Irinotecan DEB (7 of the total treatments). Results. The planned preprocedural dosage was a median of 75 mg (range 19–200), with total hepatic dose exposure being a median of 150 mg (range 0–458), with a technical success rate of 97% in all 29 treatments. There were 4 adverse events related to treatment, but no evidence of hepatic insufficiency. Overall 6-month and 12-month response rates were 50%. After a median followup of 24 months, the median overall survival in this cohort was 14 months (range 7–48 months). Conclusion. Drug-eluting beads loaded with doxorubicin (DEBDOX) or irinotecan (DEBIRI) can be safely and effectively used in treatment of patients with liver predominant metastatic disease from lung cancer

الفائض التسويقي من الألبان في القرية المصرية

There is a deficit in domestic milk production to cover the national Consumption. The gap between consumption and production reached about 1.3 million tons in 2014.the slow growth in domestic production Indicates that such gap is expecting to expand in the future. The traditional mixed farming system which is the common agricultural system in the Egyptian villages produces about 82% of the domestic annual milk production in Egypt. However, the traditional farmers suffer from poor marketing system including unfair transactions. The study relied on another field survey designed and performed by this study through a Questionnaire. The data were collected during the year 2016 to cover the agricultural year 2015/ 2016. The sample size was 60 farms from two villages in Sharkia governorate. One village was near the urban markets and the other relatively far from those markets. Such field sample survey data were used to estimate an economic model of the dairy market surplus in the Egyptian village. The results of the economic model of the dairy market surplus in the Egyptian village showed that every additional 1- kg of milk production from adds about 0.87 kilograms to the milk marketed surplus. While a same increase of cow milk adds about 0.82 kilogram to the marketed surplus., the rest of the marginal increase, is directed to the consumption of the farm household. While the village fare from the urban market sold 64% of the milk marketed surplus to the wholesalers, only 46% was sold from the other village close to the market to the same outlet. The module, also showed that the market milk surplus from the village near the urban markets increased by 408 kilogram of buffalo milk and by 511 cow milk above that sold from the village far from the urban markets

ACE gene polymorphism and serum ACE level with Progression of Nephropathy in Type 2 Diabetic Patients

Background. One of the most common complications of diabetes mellitus (DM) is diabetic nephropathy (DN).  Angiotensin- converting enzyme (ACE) gene was the first candidate gene of renin-angiotensin system (RAS) for predisposition to DN.Objective. Investigation whether the ACE insertion/deletion (I/D) polymorphism is associated with Egyptian type 2 diabetic patients (T2DM) with nephropathy. In addition, the study investigated the relationship between variants of ACE I/D gene polymorphism and serum ACE level and the progression of nephropathy in Egyptian T2DM patients.Methods.  A total of 85 T2DM patients (45 with nephropathy and 40 without nephropathy) besides 45 healthy (non-diabetic) age-matched subjects were recruited in this study for comparison. The (I/D) polymorphism of the ACE gene was investigated using PCR and serum ACE levels were determined using ELISA.Results. The frequency of ACE DD genotype and D allele was significantly higher in DN patients when compared to control healthy subjects and diabetic patients without nephropathy. In addition our results showed a significant association between DD genotype of ACE gene and elevated serum ACE level.Conclusion. The present study showing a strong association between the D allele and/or DD homozygous of ACE gene and diabetic patients developed nephropathy. In addition, individuals with D allele have higher levels of serum ACE compared to those having I allele. ACE gene polymorphism and serum ACE level may serve as a susceptibility biomarker for nephropathy in type 2 diabetic patients.Â

Effect of Pilates Exercises on Cortisol Hormone and Blood Pressure Among Hypertensive Women

Background: Hypertension is a major risk factor for cardiovascular diseases such as stroke and coronary artery disease as well as causes mortality. The Pilates method is a conditioning program in hypertensive patients of the body and mind that is gaining in popularity and acceptance worldwide. Aim of Study: To determine the response of cortisol hormone level and blood pressure after Pilates exercise in hypertensive post-menopausal women. Methods: Sixty women participated in this study was selected from Belbies Central employees and outpatient clinic with age mean ± SD values in groups (A) and (B) were 52.83 ± 3.89 and 53.37 ± 3.66 years., respectively. All of them suffering from high blood pressure stage 2(systolic 140 or higher and diastolic 90 or higher), they took medications (beta blockers - vasodilator – diuretics) and postmenopausal form 1-5 years ago. The study design was pre-post study. Patients were assigned for 8weeks protocol into two groups: Group (A) received Pilates training exercises (bent knee, shoulder bridge, side kick front, side kick back, and single leg circle), while Group (B) received only anti-hypertensive medications. Group (A) performed 5 types of Pilates exercises per session for /3 sessions/ week/ 8 weeks. The outcome measures were blood pressure (systolic and diastolic), cortisol level, anticoagulant factors (prothrombin time (PT), partial prothrombin time (PTT)) and physical characteristic (weight, body mass index (BMI), and waist hip ratio) were evaluated at the baseline and the end of the study. Results: Pre- and post-treatment comparisons showed a statistically significant decrease of the measured variables in the group A (cortisol level 17.73%, systolic blood pressure 3.70%, Diastole blood pressure 5.01 %, partial prothrombin time 7.38%, where weight 2.92 %, Body mass index 2.98 %) and significant increase in prothrombin time 0.67 %. In group B cortisol level 10.48%, significant decrease in diastole blood pressure 1.73%, no significant increase in (prothrombin time 0.25%, Partial prothrombin time 0.28%, weight 0.64%, BMI 0.34%, waist hip ration 0.11%) as well as no significant decrease in systolic blood pressure 0.75

Detection of A2142G, A2142C and A2143G clarithromycin mutations in Helicobacter pylori in Alexandria University Pediatric Hospital

Background: Helicobacter pylori (H. pylori)colonizes the stomach and affect almost 50% of the world’s population. Clarithromycin is considered a cornerstone for H. pylori treatment. Emergence of clarithromycin resistance (CLR-R) has played a major role in failure of H. pylori eradication both in adults and children.  Clarithromycin resistance is mostly due to mutations in 23S rRNA gene: A2142G, A2142C, and A2143G. The aim of the current study is to determine the prevalence of CLR-R among H. pylori infected children with prior clarithromycin treatment. Materials and Methods: Multiple endoscopic gastric biopsies were collected from 50 H. pylori infected children after cessation of clarithromycin-based treatment. Samples were subjected to histopathological examinations, rapid urease test (RUT) and simultaneous molecular detection of H. pylori infection as well as CLR-R by multiplex Real-Time polymerase chain reaction (PCR). Results: Histopathological examinations and RUT revealed H. pylori in 74% and 92% of samples respectively. Molecular detection of CLR-R showed that 62.5% positive H. pylori cases were not harboring any of the tested mutations, while 25% harbored 2143A-G single mutation. Double mutations (2142A-C and 2143A-G) were detected in only 4 cases. Statistical significant correlation existed between both RUT and PCR results as well as between histopathological findings and PCR test results. Conclusions: A combination of histopathogy, RUT and multiplex PCR procedures offers a real benefit in the simultaneous diagnosis of H. pylori infection along with clarithromycin resistance status. Other mechanisms of clarithromycin resistance need to be investigated to explain treatment failure in absence of the previously detected mutations

دوال الاستهلاك والطلب الفعال الكمي والنوعي على الألبان ومنتجاتها في الحضر والريف المصري

The objectives of this study are to assess and analyze the qualitative demand for milk with income change, as an incentive for the Egyptian market capacity to achieve health, environmental and commercial qualities. As well as, the effective demand growth rate in urban and rural of Egypt, versus domestic production growth to estimate expected dairy market gap. Field sample survey data of the household budget in 2014 in Egypt, which is conducted by the Central Agency for Public Mobilization and Statistics every three years, were used. The study estimated the quantity and monetary consumption functions of urban and rural regions using the form of the double algorithmic model to estimate the elasticity of demand for the milk quality with relative change in income, which showed that the qualitative dairy demand elasticity in the Egyptian market in urban market was positive amounted to about 0.15, i.e. 10% increase in per capita annual income will raise the demand for quality by 1.5%. which it was low it was higher than such elasticity in rural region that showed a negative value. The study attributed that to the high contribution of the dairy products consumption from rural household produced by the rural family of low direct production costs so as to avoid inflated market prices for those products. The other main reason was the per capita low income and poor distribution in the rural even much more than in urban, which is hampering spending on dairy products in order to get quality specifications. The availability of health, environmental and commercial specifications require additional marketing costs and thus necessarily raises the price of dairy products which doesn't agree with low standard of among the majority of the population, especially in the rural. The study recommends the need to consider providing incentives to producers and marketing firms who are committed to improving quality in form place and time, without significant price rise, with tighter controls on commodity specifications to prevent deception and perishable cheating and fraud, stimulate the vertical and horizontal integration between the stages of the market and also stimulate the marketing of large firms to achieve the economies of scale and consequently low cost products. The estimates of the effective demand growth rate for dairy products in urban and rural were much higher than the domestic production growth rate, showing expected expansion in the market gap in the future, especially with the expected high economic growth that expected to occur with improving in the performance of the Egyptian economy, which increases the financial burden on imports and causing higher prices for dairy products. The study recommends exploiting Egypt's comparative advantage in increasing production and raising the efficiency of marketing system to increase the supply of local production

Regional contributions of six preventable risk factors to achieving the 25 × 25 non-communicable disease mortality reduction target: a modelling study

Background Countries have agreed to reduce premature mortality from the four main non-communicable diseases (NCDs) by 25% from 2010 levels by 2025 (referred to as the 25 × 25 target). Countries also agreed on a set of global voluntary targets for selected NCD risk factors. Previous analyses have shown that achieving the risk factor targets can contribute substantially towards meeting the 25 × 25 mortality target at the global level. We estimated the contribution of achieving six of the globally agreed risk factor targets towards meeting the 25 × 25 mortality target by region. Methods We estimated the eff ect of achieving the targets for six risk factors (tobacco and alcohol use, salt intake, obesity, and raised blood pressure and glucose) on NCD mortality between 2010 and 2025. Our methods accounted for multicausality of NCDs and for the fact that, when risk factor exposure increases or decreases, the harmful or benefi cial eff ects on NCDs accumulate gradually. We used data for risk factor and mortality trends from systematic analyses of available country data. Relative risks for the eff ects of individual and multiple risks, and for change in risk after decreases or increases in exposure, were from reanalyses and meta-analyses of epidemiological studies. Findings The probability of dying between the ages 30 years and 70 years from the four main NCDs in 2010 ranged from 19% in the region of the Americas to 29% in southeast Asia for men, and from 13% in Europe to 21% in southeast Asia for women. If current trends continue, the probability of dying prematurely from the four main NCDs is projected to increase in the African region but decrease in the other fi ve regions. If the risk factor targets are achieved, the 25 × 25 target will be surpassed in Europe in both men and women, and will be achieved in women (and almost achieved in men) in the western Pacifi c; the regions of the Americas, the eastern Mediterranean, and southeast Asia will approach the target; and the rising trend in Africa will be reversed. In most regions, a more ambitious approach to tobacco control (50% reduction relative to 2010 instead of the agreed 30%) will contribute the most to reducing premature NCD mortality among men, followed by addressing raised blood pressure and the agreed tobacco target. For women, the highest contributing risk factor towards the premature NCD mortality target will be raised blood pressure in every region except Europe and the Americas, where the ambitious (but not agreed) tobacco reduction would have the largest benefi t. Interpretation No WHO region will meet the 25 × 25 premature mortality target if current mortality trends continue. Achieving the agreed targets for the six risk factors will allow some regions to meet the 25 × 25 target and others to approach it. Meeting the 25 × 25 target in Africa needs other interventions, including those addressing infectionrelated cancers and cardiovascular disease

Signaling mechanisms of a water soluble curcumin derivative in experimental type 1 diabetes with cardiomyopathy

BACKGROUND: Curcumin exhibits anti-diabetic activities, induces heme-oxygenase-1 (HO-1) and is an inhibitor of transcriptional co-activator p300. A novel water soluble curcumin derivative (NCD) has been developed to overcome low invivo bioavailability of curcumin. We evaluated the effect of the NCD on signaling mechanisms involved in cardiomyocyte hypertrophy and studied whether its action is mediated via inducible HO-1. MATERIALS AND METHODS: Rats were divided into controls, controls receiving NCD, diabetic, diabetic receiving NCD, diabetic receiving pure curcumin, diabetic receiving HO inhibitor, zinc protoporphyrin IX (ZnPP IX) and diabetic receiving NCD and ZnPP IX. NCD and curcumin were given orally. After 45 days, cardiac physiologic parameters, plasma glucose, insulin, glycated hemoglobin (GHb), HO-1 gene expression and HO activity in pancreas and cardiac tissues were assessed. Gene expression of p300, atrial natriuretic peptide (ANP) and myocyte enhancer factor 2 (MEF2A and MEF2C) were studied. RESULTS: NCD and curcumin decreased plasma glucose, GHb and increased insulin levels significantly in diabetic rats. This action may be partially mediated by induction of HO-1 gene. HO-1 gene expression and HO activity were significantly increased in diabetic heart and pancreas. Diabetes upregulated the expression of ANP, MEF2A, MEF2C and p300. NCD and curcumin prevented diabetes-induced upregulation of these parameters and improved left ventricular function. The effect of the NCD was better than the same dose of curcumin

Detection of the Timing of Human Skin Wounds by Immunohistochemical Analysis of CD14

Determination of time of injury is one of the most important topics in forensic autopsy. Several researches have been developed to estimate wound age, unfortunately with limited success. The aim of the present work was to evaluate the efficacy of Cluster of Differentiation 14 (CD14) as a reliable marker for estimating wound age. The study was conducted on forty bodies of victims with different types of wound and known infliction time. Skin samples were obtained during autopsy from the center of the wound. Sections from samples were histologically examined by H & E stain. Immunohistochemical staining was done using CD14 antibody and the staining density was evaluated semi-quantitatively. There was a statistically significant relation between wound age and percentage of CD14 expression. Expression of CD14 was 61.81±6.55 % in specimens from wounds aged less than 12 hours. It increased till reaching its maximum (96.40±3.78 %) for wounds aged between 1-3 days. Then it decreased dramatically to 14.80±3.49 % in wounds older than 3 days. CD14 is proved to be a reliable marker for estimating wound age. It gave best results in wounds aged between 1-3 days with an overall accuracy of 100%. Accordingly, it can be used to determine wound age in medicolegal practice