Evaluation of polymorphonuclear leukocyte elastase levels in neonatal sepsis

Background: Sepsis is an important cause of neonatal morbidity and mortality. In Egypt, A multi-center study reported that 45.9% of the neonates admitted to neonatal intensive care units (NICUs) were due to suspected neonatal sepsis. Proper management is not guaranteed due to nonspecific symptoms and signs especially at the onset of disease, delay of culture results and high rate of false negative results. Attempts have been made to use hematologic parameters, acute phase reactants and cytokine profiles for early and accurate diagnosis of neonatal sepsis; however, none was adequately sensitive or specific. Polymorphonuclear elastase (PMN-E) is a serine protease secreted during inflammatory diseases. The aim of the current study was to explore the reliability of PMN-E level for the diagnosis of neonatal sepsis and assess response to treatment in comparison to hematological parameters and C - reactive protein (CRP).Methods: The study comprised 30 neonates with proven sepsis, 30 neonates as control group. Both groups were subjected to calculation of hematologic sepsis score (HSS), CRP measurement, blood culture and serum PMN-E levels, the latter was measured both at diagnosis and 6 days after treatment in sepsis group.Results: Serum PMN-E levels were significantly higher in sepsis group (118.4±21.8) than in control group (57.9±27.9) and the best cut-off value was at 85 ng/ml with 97% sensitivity and 81% specificity, PMN-E levels also decreased significantly with response to treatment.Conclusions: Raised PMN-E level was found to be a diagnostic and prognostic marker in neonates with sepsis comparable with CRP and HSS

Dehydroepiandrosterone sulfate level and knee osteoarthritis in older adults: preliminary data for the possible link

ABSTRACT Background: Dehydroepiandrosterone (DHEA) is believed to be protective against articular cartilage injury and it is widely used as one of the natural remedies for inflammatory and degenerative arthritis. Yet, information about the association between DHEA level and knee OA is lacking. Objectives: To explore the link between serum dehydroepiandrosterone sulfate (DHEAs) levels and knee OA among elderly patients. Methods: A case control study was conducted on 80 elderly subjects (40 males, 40 females) aged 60 years and older attending the outpatient clinics in Ain Shams University Hospital. Participants underwent a standard clinical examination of the knee, assessment of physical difficulty and pain severity using WOMAC OA index. Weight-bearing anteroposterior radiographs of the knees in the semi-flexed position were performed. Serum levels of DHEAs were examined. Results: The serum level of DHEAs in males with knee OA was 0.29 ± 0.17 μg/mL compared to those without knee OA 0.59 ± 0.51 μg/mL (p=0.006), small but significant difference existed between the serum level of DHEAs in females with knee OA 0.25 ± 0.11 μg/mL compared to those without knee OA 0.39 ± 0.26 μg/mL (p=0.044*). Additionally, the serum DHEAs level negatively correlated with the severity of knee OA in both sexes. Conclusions: There was a sex difference in serum DHEAs level and occurrence of knee OA. Lower levels of DHEAs were reported in elderly with knee OA and the serum DHEAs level negatively correlated with the severity of knee OA

Relational ageing: on intra-gender and generational dynamism amongst ageing Latvian women

In this paper I conceptualise relational ageing in spatial and comparative terms by comparing the life stories and practices of Latvian women who migrated with those who did not. By counterposing the literatures on global care and gender contracts, I make a plea for a time- space attentive geographical approach to ageing migrants, their pre-migration experiences and ongoing relations between migrants and non-migrants. Firstly, I present some lesser-known dynamics of women-to-women (intra-gender) relations in these two groups. Secondly, I nuance relational effects in contexts when women are ageing but the man is absent from care responsibilities. And thirdly, I focus on cross-generational relations narrated and practised by ageing women abroad and those who stayed in Latvia throughout their lives

From Nuevo León to the USA and Back Again: Transnational Students in Mexico

The movement of Mexicans to the United States is both longstanding and long studied and from that study we know that for many newcomers the attachment to the receiving community is fraught and tentative. The experience of immigrant children in U.S. schools is also relatively well studied and reveals challenges of intercultural communication as well as concurrent and contradictory features of welcome and unwelcome. What is less well known, in the study of migration generally and of transnational students in particular, is how students moving in a less common direction — from the U.S. to Mexico — experience that movement. Based on visits to 173 randomly selected classrooms in the state of Nuevo León Mexico, this study shares survey and interview data from 208 of the 242 students encountered who had previous experience attending school in the United States

Migration and Health: A Framework for 21st Century Policy-Making

In the introductory article to a six-part PLoS Medicine series on Migration & Health, series guest editors Cathy Zimmerman, Mazeda Hossain, and Ligia Kiss outline a migratory process framework that involves five phases: pre-departure, travel, destination, interception, and return

Ageing and Long-Term Care Planning Perceptions of Hispanics in the USA: Evidence from a Case Study in New London, Connecticut

This paper explores the ageing attitudes and long-term care planning behavior of adult Hispanics in New London, Connecticut, a town with 30 thousand inhabitants that is rapidly ageing. We conducted six focus groups and had 37 participants share their ageing perceptions and long-term care needs. Our main findings suggest that informal care arrangements are vulnerable and unsustainable especially since women have historically and disproportionately provided most family eldercare even at their own personal and financial expense. Though male participants expected their female relatives to care for them when they age and need personal assistance, female participants did not necessarily expect the same from their relatives including their daughters. Also, both formal and government long-term care systems lack cultural competence and can be prohibitively costly. Therefore, Hispanics plan for ageing within their circles of family care and their resilience in a context of cultural exclusion and socio-economic disadvantage epitomizes strong intergenerational values. These support networks may help explain why may outlive whites (the Hispanic paradox ) who, on average, have higher wealth and education levels. Long-term care planning is a complex process that cannot be relayed to families only. Adequate training for family members from other relatives, and from private and government entities to appropriately convey this type of planning is vital to ensure that Hispanic families understand their options