Autonomic Dysfunction Predicts Early Cardiac Affection in Patients with Systemic Sclerosis

Objective: To detect the early preclinical alterations in cardiac autonomic control as well as altered cardiac function in systemic sclerosis (SSc) patients and their relevance to the clinical features of the disease using noninvasive methods. Methods: 30 SSc patients and 15 healthy controls matched for age and sex underwent clinical examination, serological analysis, and echocardiographic assessment including Doppler flow imaging to evaluate cardiac function, and 24-hour Holter monitoring analyzed for arrhythmia and heart rate variability (HRV) in the time and frequency domains. Results: The trans-mitral Doppler of early to atrial wave (E/A) ratio was reversed in five patients (16.6%) and the tricuspid E/A ratio was reversed in 10 patients (33.3%). Holter analysis for SSc patients revealed an increased prevalence of premature ventricular contractions (PVC) $ 10/h (P = 0.02), supra-ventricular tachycardias (SVTs) (P = 0.2), and total PVC count (P = 0.0000). Highly significant (P = 0.000) impairment in all HRV parameters was demonstrated in the SSc patients. Total skin thickness score (TSS), Raynaud’s phenomenon and anti-scleroderma 70 (anti-SCL70) showed significant positive correlations with all arrhythmia parameters, while showing a significant negative correlation with the impaired ventricular diastolic function and various HRV parameters. No correlation was found between arrhythmia and HRV parameters and disease duration, disease type, or presence of anti-centromere antibodies. Conclusion: Low heart rate variability, increased TSS and the presence of anti-SCL70 are correlated with preclinical cardiac involvement in SSc patients and may predict the likelihood of malignant arrhythmia and sudden cardiac death. Therefore, noninvasive HRV evaluation before clinical cardiac involvement in these patients might be beneficial when added to the clinical and laboratory assessments in detecting high-risk patients, and may allow for implementation of preventive measures and initiation of appropriate therapy early in the course of the disease

POTENTIAL ROLE OF HAEMATOCOCCUS PLUVIALIS AGAINST DIABETES INDUCED OXIDATIVE STRESS AND INFLAMMATION IN RATS

Objective: The aim of this study is to investigate the impact of Haematococcus pluvialis extract against oxidative stress and inflammatory cytokines induced by hyperglycemia in diabetic rats.Methods: Oxidative stress; lipid peroxide (as presented by Malondialdehyde; MDA) and nitric oxide (NO), beside total antioxidant capacity, enzymatic and non-enzymatic antioxidants including reduced glutathione, glutathione peroxidase, and glutathione reductase were evaluated. The inflammatory cytokines; tumor necrosis factor-alpha and interleukin-1 beta were also investigated in rats' serum. Several analyses including expression of antioxidant enzyme related genes, reactive oxygen species (ROS) formation and DNA adducts were performed.Results: The results showed that diabetes mellitus induced-rats exhibited increase in oxidative stress biomarkers and inflammatory cytokines, lower expression levels of the antioxidant enzyme genes; superoxide dismutase and glutathione S-transferase than those in control rats. In addition, diabetic rats exhibited significantly higher levels of ROS generation and 8-hydroxy-2'-deoxyguanosine (8-OHdG) formation. In contrary, supplementation of diabetic rats with H. pluvialis extract improved the negative effect of the hyperglycemia on antioxidant enzymes, the gene expression of antioxidant enzymes, and ROS generation as well as 8-OHdG formation.Conclusion: H. pluvialis extract decreased the oxidative stress, enhanced antioxidant status and inflammatory cytokines induced by hyperglycemia in diabetic rats. The effect of H. pluvialis extract involved in the increase of expression levels of antioxidant enzyme genes; decreased the levels of ROS generation and 8-OHdG formation which may be attributed to the presence of astaxanthin in H. pluvialis extract.Keywords: Haematococcus pluvialis, Hyperglycemia, Diabetes mellitus, Oxidative stress, Inflammatory cytokines, DNA adducts

Grafting Improves Fruit Yield of Cucumber Plants Grown under Combined Heat and Soil Salinity Stresses

[EN] Improving the productivity of cucumber (Cucumis sativus L.) plants subjected to combined salinity and heat stresses is a significant challenge, particularly in arid and semi-arid regions. Gianco F1 cucumbers were grafted onto five cucurbit rootstocks and, together with an ungrafted control, were grown in Egypt in a net house with saline soil during the summer season over two years. The vegetative growth, yield, quality, biochemical, and mineral composition traits were measured. Although many differences were observed among treatments, in general, the grafted plants had a performance better than or similar to that of the ungrafted plants, based on the different parameters measured. In particular, the cucumber plants grafted onto the Cucurbita maxima x C. moschata interspecific hybrid rootstocks VSS-61 F1 and Ferro had the highest early and total marketable yields. These two rootstocks consistently conferred higher vigor to the scion, which had lower flower abortion rates and higher chlorophyll contents. The fruit quality and N, P, and K composition in the leaves suffered few relevant changes as compared with the control. However, the leaves of the VSS-61 F1 had higher catalase activity, as well as proline and Se contents, while those of Ferro had higher Si content. This study reveals that the grafting of cucumber plants onto suitable rootstocks may mitigate the adverse effects caused by the combination of saline soil and heat stresses. This represents a significant improvement for cucumber cultivation in saline soil under high-temperature stress conditions in arid regions.Bayoumi, Y.; Abd-Alkarim, E.; El-Ramady, H.; El-Aidy, F.; Hamed, E.; Taha, N.; Prohens Tomás, J.... (2021). Grafting Improves Fruit Yield of Cucumber Plants Grown under Combined Heat and Soil Salinity Stresses. Horticulturae. 7(3):1-14. https://doi.org/10.3390/horticulturae70300611147

Value of Entheseal Ultrasonography and Serum Cartilage Oligomeric Matrix Protein in the Preclinical Diagnosis of Psoriatic Arthritis

Objective: To evaluate the utility of entheseal ultrasonography and serum COMP in the preclinical diagnosis of psoriatic arthritis. Methods: 60 psoriatic patients were divided into: 30 patients with psoriasis (group I) and 30 patients with psoriatic arthritis as control (group II). They underwent independent clinical and ultrasonographic examination of both lower limbs at the calcaneal insertions of Achilles tendons. Psoriatic arthritis disease activity and severity was assessed by modified DAS28 and Steinbrockers scores. Serum levels of COMP were measured for all patients by ELISA. Results: On clinical examination, no entheseal abnormalities were detected in group I while they were present in 23.3% of group II with statistically significant difference between them (P < 0.001). Ultrasonographic entheseal abnormalities were detected in 33.3% of group I and in 46.7% of group II with no significant difference between them (P > 0.05). Serum COMP were significantly elevated in group I and II with no statistically significant difference between them (mean ± SD 5.9 ± 3 and 6.8 ± 12 respectively, P > 0.05). Entheseal ultrasound was more specific (67%) while serum COMP was more sensitive (87%) in the preclinical diagnosis of psoriatic arthritis. Serum COMP levels were significantly correlated with CRP in both groups and with DAS28 and Steinbrockers scores in group II (P < 0.01). Conclusion: Entheseal ultrasonography and serum COMP levels may be used complementary to each other for preclinical diagnosis of psoriatic arthritis. Serum COMP seems to be promising prognostic marker for psoriatic arthritis patients

Association between genetic polymorphism, severity, and treatment response among COVID-19 infected Egyptian patients

Background: The world has been suffering from the Coronavirus Disease-2019 (COVID-19) pandemic since the end of 2019. The COVID-19-infected patients differ in the severity of the infection and the treatment response. Several studies have been conducted to explore the factors that affect the severity of COVID-19 infection. One of these factors is the polymorphism of the angiotensin converting enzyme 2 (ACE-2) and the type 2 transmembrane serine protease (TMPRSS2) genes since these two proteins have a role in the entry of the virus into the cell. Also, the ACE-1 regulates the ACE-2 expression, so it is speculated to influence the COVID-19 severity.Objective: This study investigates the relationship between the ACE-1, ACE-2, and TMPRSS2 genes single nucleotide polymorphism (SNPs) and the COVID-19 disease severity, treatment response, need for hospitalization, and ICU admission in Egyptian patients.Patients and Methods: The current study is an observational prospective, cohort study, in which 109 total COVID-19 patients and 20 healthy volunteers were enrolled. Of those 109 patients, 51 patients were infected with the non-severe disease and were treated in an outpatient setting, and 58 suffered from severe disease and required hospitalization and were admitted to the ICU. All 109 COVID-19 patients received the treatment according to the Egyptian treatment protocol.Results: Genotypes and allele frequencies among severe and non-severe patients were determined for ACE-1 rs4343, TMPRSS2 rs12329760, and ACE-2 rs908004. The GG genotype and the wild allele of the ACE-2 rs908004 and the mutant allele of the ACE-1 rs4343 were significantly more predominant in severe patients. In contrast, no significant association existed between the TMPRSS2 rs12329760 genotypes or alleles and the disease severity.Conclusion: The results of this study show that the ACE-1 and ACE-2 SNPs can be used as severity predictors for COVID-19 infection since also they have an effect on length of hospitalization

The outcome of ultrasound-guided insertion of central hemodialysis catheter

Objective: To point out our experience and assess the efficacy and safety of real-time ultrasound-guided central internal jugular vein (IJV) catheterization in the treatment of hemodialysis patients. Methods: This retrospective study comprised 150 patients with end-stage renal disease (ESRD) who had real-time ultrasonography (US)-guided IJV HD catheters placed in our hospital between March 2019 and March 2021. Patients were examined for their demographic data, etiology, site of catheter insertion, type (acute or chronic) of renal failure, technical success, operative time, number of needle punctures, and procedure-related complications. Patients who have had multiple catheter insertions, prior catheterization challenges, poor compliance, obesity, bony deformity, and coagulation disorders were considered at high-operative risk. Results: All patients experienced technical success. In terms of patient clinical features, an insignificant difference was observed between the normal and high-risk groups (p-value > 0.05). Of the 150 catheters, 62 (41.3%) were placed in high-risk patients. The first-attempt success rate was 89.8% for the normal group and 72.5% for the high-risk group (p = 0.006). IJV cannulation took less time in the normal-risk group compared to the highrisk group (21.2 ± 0.09) minutes vs (35.4 ± 0.11) minutes, (p < 0.001). There were no serious complications. During the placing of the catheter in the internal jugular vein, four patients (6.4%) experienced arterial puncture in the high-risk group. Two participants in each group got a small neck hematoma. One patient developed a pneumothorax in the high-risk group, which was managed with an intercostal chest tube insertion. Conclusions: Even in the high-risk group, the real-time US-guided placement of a central catheter into the IJV is associated with a low complication rate and a high success rate. Even under US guidance, experience lowers complication rates. Real-time USguided is recommended to be used routinely during central venous catheter insertion

Use of Posttranscription Gene Silencing in Squash to Induce Resistance against the Egyptian Isolate of the Squash Leaf Curl Virus

Squash leaf curl virus (SqLCV) is a bipartite begomovirus affecting squash plants. It is transmitted by whitefly Bemisia tabaci biotype B causing severe leaf curling, vein banding, and molting ending by stunting. In this study full-length genomic clone of SqLCV Egyptian isolated and posttranscriptional gene silencing (PTGS) has been induced to develop virus resistance. The Noubaria SqLCV has more than 95% homology with Jordon, Israel, Lebanon, Palestine, and Cairo isolates. Two genes fragment from SqLCV introduced in sense and antisense orientations using pFGC5049 vector to be expressed as hairpin RNA. The first fragment was 348 bp from replication associated protein gene (Rep). The second fragment was 879 bp representing the full sequence of the movement protein gene (BC1). Using real-time PCR, a silencing record of 97% has been recorded to Rep/TrAP construct; as a result it has prevented the appearance of viral symptoms in most tested plants up to two months after infection, while construct containing the BC1 gene scored a reduction in the accumulation of viral genome expression as appearing in real-time PCR results 4.6-fold giving a silencing of 79%, which had a positive effect on symptoms development in most tested plants

Platelet indices as markers of inflammation in systemic sclerosis patients: Relation to vascular endothelial growth factor and flow mediated dilatation

Aim of the work: To evaluate platelet indices in systemic sclerosis (SSc) patients and identify their clinical significance as novel inflammatory biomarkers in correlation to markers of endothelial dysfunction: vascular endothelial growth factor (VEGF) and flow mediated dilatation (FMD). Patients and methods: Thirty-five SSc patients were enrolled in addition to 35 age and sex matched healthy volunteers as controls. All patients and controls underwent full medical history taking, thorough clinical examination, assessment of severity extent of skin sclerosis using the modified Rodnan skin score (mRss), erythrocyte sedimentation rate (ESR), C- reactive protein (CRP), complete blood count with special consideration to mean platelet volume (MPV), platelet distribution width and platelets count, assay for serum VEGF concentration, and brachial FMD assessment by color duplex sonography. Results: There was a highly significant decrease in the mean MPV in SSc patients compared to the controls (8.65 ± 0.6 fl vs. 9.55 ± 0.52 fl). There was a significant increase in the mean platelet count in SSc patients compared to controls (331.63 ± 64.66 × 103/ml vs. 297.80 ± 44.48 × 103/ml). In SSc patients, a significant negative correlation was found between the mean MPV and each of ESR, CRP and VEGF (r = −0.42, r = −0.37 and r = −0.55 respectively, p < .05); and a significant positive correlation was found between the mean MPV and mean FMD (r = 0.38, p < .05). Linear regression test, showed an association between mean MPV and each of ESR and CRP (t = −3.31, −2.92 respectively, p < .05). Conclusion: MPV levels could be an easily measurable parameter to reflect the inflammatory condition in systemic sclerosis patients. Keywords: Systemic sclerosis (SSc), Platelet indices, Vascular endothelial growth factor (VEGF), Flow mediated dilatation (FMD

Anti-carbamylated protein antibodies in psoriatic arthritis patients: Relation to disease activity, severity and ultrasonographic scores

Background: Anticarbamylated proteins (anti-CarP) are a novel family of antibodies recently identified in patients with inflammatory arthritis. Aim of the work: To investigate the anti-CarP serum levels in psoriatic arthritis (PsA) patients. The relation of anti-CarP to disease activity and severity as well as to the ultrasonographic findings and scores were well thought-out. Patients and methods: Forty-five PsA patients diagnosed according to the classification of psoriatic arthritis (CASPAR) criteria. 45 matched controls were included. The erythrocyte sedimentation rate (ESR), C-reactive protein and serum anti-CarP antibody were measured. PsA disease activity was recorded according to the modified disease activity score (DAS28). The severity and extent of psoriasis was assessed by the psoriasis area severity index (PASI). Musculoskeletal ultrasound (US) of the small hand joints was performed using grey scale (GS) and power Doppler (PD) to derive composite scores based on abnormal counts and severity. Results: The mean age of the patients was 44.58 ± 6.76 years, 40 females and 5 males (F:M 8:1), disease duration 4.93 ± 3.17 years. Serum levels of anti-CarP antibody were increased in PsA patients (33.48 ± 14.05) compared to controls (12.21 ± 4.71 ng/ml) (p < 0.001). The mean DAS28 was 4.61 ± 1.59 There was a significant correlation between anti-CarP antibody and each of DAS28, ESR, CRP, PASI, the GS and PD joint counts (r = 0.97, r = 0.97, r = 0.97, r = 0.97, r = 0.96, r = 0.9 respectively) as well as with the US joint scores; GSJS and PDJS (r = 0.98, r = 0.97 respectively) denoting severity. Conclusions: Anti-CarP antibody might represent a promising marker to predict joint damage and disease activity in PsA patients