Biochemical composition and antioxidant properties of some seaweeds from Red Sea coast, Egypt

The current study investigated the biochemical composition and antioxidant properties of four seaweeds: Laurencia sp. (Rhodophyta), Cystoseira myrica, Hydroclathrus clathratus and Padina pavonica (Ochrophyta). The highest amount of carbohydrates was (215.78 mg/g dry wt.) in Laurencia sp. and proteins content was maximum (50 mg/g dry wt.) in Laurencia sp. and Cystoseira myrica. The highest values of free amino acid content were recorded in the brown seaweed species Cystoseira myrica (4.01 mg/g dry wt.). The pressurized hot water extract of Cystoseira myrica has the highest total phenolic content (1.61 mg GAE/g dry wt.). Cystoseira myrica contained the highest amounts of flavonoids (3.35 mg/g dry wt.), ascorbic acid (9.07 mg/g dry wt.) and α-tocopherol (27.25±0.00 abs. at 520 nm/g dry wt.). Furthermore, the ethyl alcohol extract of Cystoseira myrica showed high antioxidant capacities (541.6 mg/g dry wt.) and achieved the most powerful reducing ability among all of the different extracts of algal species. Statistical evaluation by Spearman correlation between the TAC assay and the total phenolic contents was found to be significant, but the correlation was nonsignificant between FRAP assay and the total phenolic contents. The composition of elements of the studied seaweed species was also analyzed. The most significant macro-elements present in the studied seaweeds were K, Na and Ca, representing that the seaweeds are good sources of these elements. Since, these seaweeds are widespread in the Egyptian waters, their biochemical composition and antioxidant capacities made them promising candidates for industrial, nutritional and pharmaceutical applications. DOI: http://dx.doi.org/10.5281/zenodo.147886

The Youngest Palestinian Case of Multisystem Inflammatory Syndrome in children (MIS-C)

The multisystem inflammatory syndrome in children (MIS-C) considers a post-infectious immunological response to coronavirus illness (COVID-19) that was originally identified in the United Kingdom and later identified in other countries.  A previously healthy 3-month-old boy was admitted to hospital context with -5-day history of fever, gastrointestinal symptoms [diarrhea, vomiting of normal gastric contents], hypoactivity, and poor oral intake, but so far no history of covid-19 active disease. The infant was dehydrated, with macular non-blanching skin rash everywhere over his body and widespread non-pitting edema. With supportive measures, methylprednisolone and IV immunoglobulin, the child improved, with his fever, skin rash, and laboratory tests returning to normal. On the seventh day of hospitalization, he was discharged. This is identified as the youngest reported case of MIS-C since the beginning of the COVID-19 pandemi

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London

Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study

Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. Methods: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231. Findings: Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p < 0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p < 0·001). Interpretation: Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication

Musculoskeletal ultrasound on the hand and wrist in systemic sclerosis

Background Systemic sclerosis (SSc) is a chronic autoimmune connective tissue disorder. Musculoskeletal involvement represents a major cause of disability in SSc, which is localized especially at the level of the hands and feet. Musculoskeletal ultrasound (MSUS) had become a reference imaging tool in the evaluation of joint and soft-tissue abnormalities in rheumatic diseases. Aim of the work This study aimed to characterize ultrasonographic changes of the hand and wrist in patients with SSc as compared with patients with rheumatoid arthritis (RA), as well as determine the relation of these changes with clinical, laboratory, and radiographic findings in SSc. Patients and methods Twenty SSc patients and 20 control RA patients were included in this study. All patients underwent history taking, clinical examination, hand/wrist plain radiography, and MSUS performed on both hand and wrist joints. Results MSUS was more sensitive than radiographies in detecting soft-tissue calcifications in SSc patients and also in detecting erosions with no statistically significant difference (P > 0.05). In SSc patients, the prevalence of synovitis and tenosynovitis detected by ultrasound was found to be statistically significantly higher than that found by clinical examination (P = 0.025 and 0.011, respectively). Patients with higher values of erythrocyte sedimentation rate and C-reactive protein were more likely to have synovitis and/or tenosynovitis and inflammatory activity on power Doppler assessment. Conclusion Ultrasound was more accurate than clinical examination and conventional radiography in the detection of subclinical synovitis, tenosynovitis, and the underlying fibrotic changes of tendon friction rub. In SSc patients, on using MSUS, articular involvement was found to be less frequent compared with that in RA patients, with specific appearance of sclerosing tenosynovitis in SSc patients

Biochemical composition and antioxidant properties of some seaweeds from Red Sea coast, Egypt

The current study investigated the biochemical composition and antioxidant properties of four seaweeds: Laurencia sp. (Rhodophyta), Cystoseira myrica, Hydroclathrus clathratus and Padina pavonica (Ochrophyta). The highest amount of carbohydrates was (215.78 mg/g dry wt.) in Laurencia sp. and proteins content was maximum (50 mg/g dry wt.) in Laurencia sp. and Cystoseira myrica. The highest values of free amino acid content were recorded in the brown seaweed species Cystoseira myrica (4.01 mg/g dry wt.). The pressurized hot water extract of Cystoseira myrica has the highest total phenolic content (1.61 mg GAE/g dry wt.). Cystoseira myrica contained the highest amounts of flavonoids (3.35 mg/g dry wt.), ascorbic acid (9.07 mg/g dry wt.) and α-tocopherol (27.25±0.00 abs. at 520 nm/g dry wt.). Furthermore, the ethyl alcohol extract of Cystoseira myrica showed high antioxidant capacities (541.6 mg/g dry wt.) and achieved the most powerful reducing ability among all of the different extracts of algal species. Statistical evaluation by Spearman correlation between the TAC assay and the total phenolic contents was found to be significant, but the correlation was nonsignificant between FRAP assay and the total phenolic contents. The composition of elements of the studied seaweed species was also analyzed. The most significant macro-elements present in the studied seaweeds were K, Na and Ca, representing that the seaweeds are good sources of these elements. Since, these seaweeds are widespread in the Egyptian waters, their biochemical composition and antioxidant capacities made them promising candidates for industrial, nutritional and pharmaceutical applications. DOI: http://dx.doi.org/10.5281/zenodo.147886

Serum and synovial matrix metalloproteinase-3 as markers of disease activity in early rheumatoid arthritis

Background Matrix metalloprotein ase-3 (MMP-3) is one of the MMPs produced in rheumatoid arthritis (RA) joints. Aim The aim of this study was to evaluate serum and synovial fluid (SF) MMP-3 as markers of disease activity in early RA. Patients and methods Thirty early RA patients together with age-matched and sex-matched 12 primary knee osteoarthritis patients and 12 apparently healthy individuals as control groups were enrolled in this study. MMP-3 was measured in serum and SF samples using enzyme-linked immunosorbent assay. Assessment of disease activity in RA patients was carried out using disease activity score-28 (DAS-28), and radiographs of the hands, wrists, and forefeet were obtained and evaluated according to Larsen score. Results As regards mean serum levels of MMP-3, there was a statistically significant elevation in RA patients compared with the control groups (P<0.001). Moreover, the mean SF levels of MMP-3 in RA patients were statistically significantly higher than that in osteoarthritis patients (P<0.001). In RA patients, there was a statistically significant difference (P<0.001) between mean serum and SF levels, being higher in the SF. There was a statistically significant positive correlation (P<0.05) between serum MMP-3 with disease duration, DAS-28, and Larsen score. As regards mean SF MMP-3 levels, there was a high statistically significant positive correlation (P<0.001) with DAS-28 and a statistically significant positive correlation (P<0.05) with Larsen score. Conclusion Elevated serum and synovial MMP-3 levels reflect disease activity in RA patients; thus, it could be used as a useful marker for disease activity. The cross-sectional design of our study did not allow us to produce conclusions with respect to disease course and prognosis. Thus, we recommend further studies on large numbers of patients and serial measurements of MMP-3 to determine the rate of disease progression

Association of neutrophil to lymphocyte ratio with disease activity indices and musculoskeletal ultrasound findings in recent onset rheumatoid arthritis patients

Aim of the work: To study the relation between neutrophil-lymphocyte ratio (NLR) with disease activity indices and with musculoskeletal ultrasonographic findings in recent onset rheumatoid arthritis (RA) patients. Patients and methods: The study consisted of 40 recently diagnosed RA patients and 40 matched control. Patients’ disease activity was assessed clinically by the disease activity score (DAS-28). Musculoskeletal ultrasound was performed to detect synovitis by Power-Doppler ultrasound (PDUS). The association of NLR with the disease activity indices and the PDUS score were analyzed. Results: The mean age of the patients was 44.5 ± 2.7 years, disease duration 9.4 ± 4.5 months and the female:male ratio was 2.3:1. Their disease activity was 4.7 ± 1.33 and the PDUS score was 10.24 ± 4.56. The NLR was significantly increased in the RA patients (3.28 ± 0.59) compared to the control (1.7 ± 0.23) (p < 0.0002). There was a significant correlation between NLR with the disease duration (p < 0.015), tender joint count (p < 0.022), swollen joint count (p < 0.018), morning stiffness (p < 0.045), visual analogue scale (p < 0.026), DAS-28 (p < 0.049), erythrocyte sedimentation rate (p < 0.032), C-reactive protein (p < 0.017) and PDUS score (p < 0.037). NLR was significantly elevated in highly active RA patients compared to patients with moderate and low disease activity (p < 0.014). Conclusion: NLR significantly correlated with disease activity indices in recent onset RA patients thus reflecting systemic inflammation with its advantages of being available, easy and cost accessible being as reliable as the DAS-28 hence it could be used as a marker of disease activity

Serum level of brain-derived neurotrophic factor in fibromyalgia

Introduction Fibromyalgia syndrome (FMS) is a complex clinical syndrome that primarily affects middle-aged women. Fibromyalgia (FM) is characterized by pain associated with sleep disturbances (nonrefreshing sleep, hypersomnolence), the presence of specific painful sites (tender points), and is often accompanied by fatigue and depression. It is believed to arise from the abnormal central sensory processing of pain signals, involving the interaction between neurotransmitters, external stressors, behavioral constructs, hormones, and the sympathetic nervous system. Brain-derived neurotrophic factor (BDNF), a member of neurotrophines, is the most prevalent growth factor in the central nervous system. It is essential for the development of the central nervous system and for neuronal plasticity. Because BDNF plays a crucial role in the development and plasticity of the brain, it is widely implicated in psychiatric diseases. Aim of the work This study aimed to evaluate serum level of BDNF in FM patients and its relation with depression. Patients and methods Thirty patients with primary fibromyalgia syndrome were enrolled into this study. These patients were subjected to clinical examination and assessment of depression using the Hamilton Rating Scale for depression. Serum BDNF levels were determined using an enzyme-linked-immunosorbent assay. Twenty age-matched and sex-matched healthy volunteers were included as controls. Results The mean serum BDNF level was age-dependent in healthy controls. FMS patients had higher level of serum BDNF compared with healthy controls. In addition, serum level of BDNF showed correlation with depression, but not with other disease manifestations. The mean serum level of BDNF increased with higher values of depression score in FM patients. Conclusion BDNF is involved in the pathophysiology of FMS. Moreover, it seems to be correlated with the intensity of depression symptoms in FMS patients

Neutrophil-to-lymphocyte ratio: relation to disease activity and carotid intima-media thickness in Behçet’s disease

Background Behçet’s disease (BD) is an autoinflammatory disorder. Disease activity could be detected by changes in peripheral blood cell components. The aim of this study was to assess the relationship between neutrophil-to-lymphocyte ratio (NLR) with disease activity and carotid intima-media thickness (cIMT) in patients with BD. Patients and methods This study was conducted on 20 adult patients with BD (group І). This group was subdivided according to cIMT into group Іa, which included patients with increased cIMT, and group Іb, which included patients with cIMT within normal ranges. Moreover, 20 age-matched and sex-matched apparently healthy volunteers were included as a control group (group ІІ). Patients with BD were subjected to full history taking, thorough clinical examination, and assessment of disease activity according to Behçet’s Disease Current Activity Form score. The white blood cell count, neutrophil count, and lymphocytes count were recorded, and NLR was calculated. cIMT assessment was done for all participants. Results There were statistically significant differences (P<0.05) regarding lymphocytes count and NLR and highly statistically significant difference (P<0.001) regarding neutrophil count, being higher in patients with BD. There was a statistically highly significant difference (P<0.001) regarding cIMT, being higher in group Іa patients (0.82±0.03) than group Іb patients (0.50±0.04) and healthy control group (0.47±0.04). There was a statistically significance positive correlation (R=639, P=0.005) between NLR and Behçet’s Disease Current Activity Form score. In conclusion, higher NLR values were recorded in patients with BD. Furthermore, patients with active BD had higher NLR values than inactive, and NLR is higher in patients with increased cIMT; thus, NLR may be an important bio-index for detecting BD activity and the presence of vascular affection