Soluble CD40 ligand, interleukin (IL)-6, and hemostatic parameters in metabolic syndrome patients with and without overt ischemic heart disease

AbstractBackground and aimSoluble CD40 ligand (sCD40L, also known as CD154) is a marker for platelet activation which could increase coagulation and inflammation. In this case-control study, we aimed to assess the levels of plasma sCD40L, IL-6, and some hemostatic parameters in patients with metabolic syndrome (MetS) whether or not associated with overt ischemic heart disease (IHD).Subjects and methodsWe measured plasma sCD40L (an index of platelet activation), interleukin (IL)-6 (a proinflammatory cytokine), and some hemostatic parameters (tissue factor [TF], thrombin–antithrombin [TAT] and D-dimer) in 47 patients with metabolic syndrome (21 with and 26 without overt IHD) versus 25 comparable healthy control subjects.ResultsSignificantly higher levels of sCD40L, IL-6, and thrombotic markers (TF, D-dimer and TAT) were found in patients with metabolic syndrome compared to healthy controls. The levels of IL-6 and sCD40 were highest in patients with overt IHD. Strong positive correlations existed between sCD40L and IL-6 (r=0.67, p=0.003), TF (r=0.59, p=0.008), and platelets count (r=0.64, p=0.005).ConclusionHigher levels of sCD40L, IL-6, and thrombotic markers exist in MetS patients, particularly those with IHD. The strong positive correlations between sCD40L and IL-6, TF, and platelets count support a link between the CD40–CD40L system and the underlying inflammatory and hypercoagulable state in MetS patients

Global overview of the management of acute cholecystitis during the COVID-19 pandemic (CHOLECOVID study)

Background: This study provides a global overview of the management of patients with acute cholecystitis during the initial phase of the COVID-19 pandemic. Methods: CHOLECOVID is an international, multicentre, observational comparative study of patients admitted to hospital with acute cholecystitis during the COVID-19 pandemic. Data on management were collected for a 2-month study interval coincident with the WHO declaration of the SARS-CoV-2 pandemic and compared with an equivalent pre-pandemic time interval. Mediation analysis examined the influence of SARS-COV-2 infection on 30-day mortality. Results: This study collected data on 9783 patients with acute cholecystitis admitted to 247 hospitals across the world. The pandemic was associated with reduced availability of surgical workforce and operating facilities globally, a significant shift to worse severity of disease, and increased use of conservative management. There was a reduction (both absolute and proportionate) in the number of patients undergoing cholecystectomy from 3095 patients (56.2 per cent) pre-pandemic to 1998 patients (46.2 per cent) during the pandemic but there was no difference in 30-day all-cause mortality after cholecystectomy comparing the pre-pandemic interval with the pandemic (13 patients (0.4 per cent) pre-pandemic to 13 patients (0.6 per cent) pandemic; P = 0.355). In mediation analysis, an admission with acute cholecystitis during the pandemic was associated with a non-significant increased risk of death (OR 1.29, 95 per cent c.i. 0.93 to 1.79, P = 0.121). Conclusion: CHOLECOVID provides a unique overview of the treatment of patients with cholecystitis across the globe during the first months of the SARS-CoV-2 pandemic. The study highlights the need for system resilience in retention of elective surgical activity. Cholecystectomy was associated with a low risk of mortality and deferral of treatment results in an increase in avoidable morbidity that represents the non-COVID cost of this pandemic

Burnout among surgeons before and during the SARS-CoV-2 pandemic: an international survey

Background: SARS-CoV-2 pandemic has had many significant impacts within the surgical realm, and surgeons have been obligated to reconsider almost every aspect of daily clinical practice. Methods: This is a cross-sectional study reported in compliance with the CHERRIES guidelines and conducted through an online platform from June 14th to July 15th, 2020. The primary outcome was the burden of burnout during the pandemic indicated by the validated Shirom-Melamed Burnout Measure. Results: Nine hundred fifty-four surgeons completed the survey. The median length of practice was 10 years; 78.2% included were male with a median age of 37 years old, 39.5% were consultants, 68.9% were general surgeons, and 55.7% were affiliated with an academic institution. Overall, there was a significant increase in the mean burnout score during the pandemic; longer years of practice and older age were significantly associated with less burnout. There were significant reductions in the median number of outpatient visits, operated cases, on-call hours, emergency visits, and research work, so, 48.2% of respondents felt that the training resources were insufficient. The majority (81.3%) of respondents reported that their hospitals were included in the management of COVID-19, 66.5% felt their roles had been minimized; 41% were asked to assist in non-surgical medical practices, and 37.6% of respondents were included in COVID-19 management. Conclusions: There was a significant burnout among trainees. Almost all aspects of clinical and research activities were affected with a significant reduction in the volume of research, outpatient clinic visits, surgical procedures, on-call hours, and emergency cases hindering the training. Trial registration: The study was registered on clicaltrials.gov "NCT04433286" on 16/06/2020

Alkaloid Production and Organogenesis from Callus of Hyoscyamus muticus L. In vitro

Abstract: The effect of different concentrations of 1-naphthaleneacetic acid (NAA) and kinetin as growth regulators on callus induction and organogenesis was studied using different explants excised from seedlings of Hyoscyamus muticus L. grown on Murashige and Skoog (MS) medium. Using both hypocotyl and leaf as explants had a salutary effect on callus formation, in a media impregnated with 2 mg/L NAA and 0.5 mg/L kinetin. Best root percent formation (32.25%) was obtained using both hypocotyl and root as explants, while leaf explant gave the best shoot percent formation (60.25% ). Optimization of callus growth and its tropane alkaloid production was examined using different carbon sources, precursor and elicitor. The best callus growth was achieved on a media containing 86 mM sucrose, 0.25 mM tropic acid and 0.5 g/L yeast extract. W hile media containing 43 mM sucrose, 0.5 mM tropic acid and 2 g/L yeast extract gave the best results in alkaloid production. HPLC analysis revealed that the concentration of both hyoscyamine and scopolamine in in vitro regenerated leaves was 80% of that of the parent ones, while that of the leaf calli was only18%

Molecular Identification and Characterization of Some Gluconacetobacter Strains Isolated from Some Egyptian Fruits

ABSTRACT Three local isolates of biocellulose (BC)-producing Gluconacetobacter strains were isolated from rotten fruits out of 103 isolates. The representative isolates were selected from each of the 20 isolation sources (rotten fruits). Morphological (using Scanning of electronic microscope), physiological and biochemical characteristics examinations were done to identify the local isolates on classical level. 16S rRNA gene sequence analysis test were done were done to identify the local isolates too but on molecular genetic level. Comparison between the reference strain Gluconacetobacter xylinus NBRC 3288) A) and the three local strains; Gluconacetobacter hansenii strain UAC09 (A2), Gluconacetobacter sacchari strain DSM12717 (A3) and Gluconacetobacter xylinus E25 (A4) on Morphological, physiological and biochemical characteristics were done. Three accession numbers submission under registration in the EMBL database nucleotide; ID 1742271 for Gluconacetobacter hansenii strain UAC09, ID 1742272 for Gluconacetobacter sacchari strain DSM12717 (A3) and ID 1742273 for Gluconacetobacter xylinus E25 (A4)

Subclinical Hypothyroidism Is Independently Associated with Microalbuminuria in a Cohort of Prediabetic Egyptian Adults

BackgroundRecent evidence has suggested an association between subclinical hypothyroidism (SCH) and microalbuminuria in patients with type 2 diabetes. However, whether SCH is related to microalbuminuria among subjects with prediabetes has not been studied. Thus, we evaluated the association between SCH and microalbuminuria in a cohort of prediabetic Egyptian adults.MethodsA total of 147 prediabetic subjects and 150 healthy controls matched for age and sex were enrolled in this study. Anthropometric measurements, plasma glucose, lipid profile, homeostasis model assessment of insulin resistance (HOMA-IR), thyroid stimulating hormone (TSH), free thyroxine, triiodothyronine levels, and urinary albumin-creatinine ratio (UACR) were assessed.ResultsThe prevalence of SCH and microalbuminuria in the prediabetic subjects was higher than that in the healthy controls (16.3% vs. 4%, P<0.001; and 12.9% vs. 5.3%, P=0.02, respectively). Prediabetic subjects with SCH were characterized by significantly higher HOMA-IR, TSH levels, UACR, and prevalence of microalbuminuria than those with euthyroidism. TSH level was associated with total cholesterol (P=0.05), fasting insulin (P=0.01), HOMA-IR (P=0.01), and UACR (P=0.005). UACR was associated with waist circumference (P=0.01), fasting insulin (P=0.05), and HOMA-IR (P=0.02). With multiple logistic regression analysis, SCH was associated with microalbuminuria independent of confounding variables (β=2.59; P=0.01).ConclusionOur findings suggest that prediabetic subjects with SCH demonstrate higher prevalence of microalbuminuria than their non-SCH counterparts. SCH is also independently associated with microalbuminuria in prediabetic subjects. Screening and treatment for SCH may be warranted in those patients

Breathing pattern in asthmatic patients during exercise

Objectives: To study the effect of exercise on asthmatic breathing pattern. Background: Asthmatic patients have been reported to be breathless regardless of the degree of airway obstruction. Task performance may induce changes in breathing pattern and these in turn may mediate such a feeling. There is increasing interest in the use of breathing modification techniques in the treatment of asthma. Methods: This study was conducted on 20 asthmatic patients in stable mild state, they were selected from the Chest Department of the Menoufia University Hospital from February 2014 to September 2014. All patients were subjected to clinical history and examination, plain chest-X-ray (postero-anterior and lateral views), ECG and echo if needed, pulmonary function tests and cardiopulmonary exercise testing. Results: Breathing pattern parameters tidal volume (VT), respiratory rate (RR), minute ventilation (VE), mean inspiratory flow (VT/TI) increased during exercise then decreased during the recovery period while inspiratory time (TI) and total breath duration (Ttot) decreased during exercise then decreased during the recovery period. There was an increase in forced vital capacity (FVC), forced expiratory volume in one second (FEV1), peak expiratory flow (PEF). Forced expiratory volume in one second/forced vital capacity (FEV1/FVC) during exercise and a decrease during the recovery period while forced expiratory time (FET100%) showed an opposite change. Conclusion: Breathing pattern was altered significantly during exercise in asthmatic patients

Solid state recycling of aluminium AA6061 alloy chips by hot extrusion

In the present study, aluminium AA-6061 alloy turning chips recycled using solid-state recycling technique through cold compaction followed by hot extrusion. The effect of the extrusion ratio (ER) and extrusion temperature (ET) on the microstructure evolution, the physical properties and the mechanical properties of the produced samples were studied. Moreover, the results were compared with those of the as-received samples extruded under the same conditions (reference samples extruded under ER = 5.2 and different ET = 350, 450 and 500 degrees C). Approximately dense samples with reasonable tensile strength, elongation, and microhardness were obtained. The tensile properties (strength and elongation) of recycled samples increased with the increase of the ER and ET those improve the bonding between chips. The chip samples processed under ER of 12.8 and ET of 500 degrees C have superior mechanical properties compared to the reference samples. The fracture surfaces of the recycled samples consisted of a combination of micro-cracks and equiaxed dimples according to the degree of the bonding of the chips.11Nsciescopu