A study of annexin-V labeled-lymphocytes apoptosis in pediatric-onset systemic lupus erythematosus in comparison to juvenile rheumatoid arthritis

Background: In systemic lupus erythematosus (SLE), which is the prototype of autoimmune diseases, the autoimmune process seems to be antigen driven. Apoptosis is responsible for eliminating cells from the immune system that are autoreactive, and defects in apoptosis may contribute to autoimmune diseases such as SLE and juvenile rheumatoid arthritis (JRA). Objective: This work is aimed to study the apoptotic peripheral blood lymphocytes in patients with pediatric- onset SLE, to trace its correlations, if any, with the disease activity and clinical presentation, and to compare the apoptotic process to that in JRA, as an example of another rheumatologic disorder. Methods: The study was conducted on 32 patients with pediatric- onset SLE; their ages ranged between 5 and 25 years (mean + SD = 15.5 + 4.4). In addition to various laboratory investigations needed for diagnosis, assessment of different system involvement as well as disease activity, the percentage of early circulating apoptotic lymphocytes was measured by flowcytometry using Annexin –V. The results were compared to that of 20 age and sex matched clinically healthy children and adolescents as well as 10 JRA patients. Results: The percentage of circulating early apoptotic lymphocytes was significantly higher in SLE patients (mean ± SD = 7.02 ± 7.29 %) and JRA patients (mean ± SD=5.91± 6.00 %) as compared to healthy controls (mean ± SD = 1.89 ± 2.21 %; p=0.0003 and 0.023, respectively). The levels of apoptotic lymphocytes seemed higher in SLE patients than in JRA patients but the difference was statistically insignificant (p=0.58). There was no correlation between the percentage of circulating apoptotic lymphocytes and the disease activity markers (SLEDAI and ESR), different system involvement and the dose or duration of corticosteroids therapy. Conclusion: The general increase of circulating apoptotic lymphocytes seen in SLE patients may not be specific to SLE and could be seen with other autoimmune diseases. It seems that disturbance in the apoptotic process contributes more to the phenomenon of autoantigenicity rather than the prediction of the disease clinical activity or specific organ involvement.Keywords: SLE, apoptosis, annexin V, autoimmune diseases, JRA, PediatricEgypt J Pediatr Allergy Immunol 2003; 1(2): 118-2

Oxidative Stress in Hemodialysis Pediatric Patients

BACKGROUND: Oxidative stress may play a role in complications of hemodialysis patients as atherosclerosis, thrombosis, and inflammation. AIM: The aim of the study was to evaluate the oxidative stress in hemodialysis pediatric patients through measurement of oxidative stress enzymes as paraoxanase activity (PON), arylesterase activity (ASA), superoxide dismutase (SOD) and also non-enzymatic antioxidant vitamins as vitamins A, C and E levels. METHODS: The study included 50 hemodialysis pediatric patients with mean age 11.4 ± 5.4 years and 30 normal children of matched sex and age as a control group. Assessment of oxidative stresses was done using ELIZA technique. RESULTS: SOD, ASA, and vitamin C were significantly lower among hemodialysis patients in comparison to control group (p = 0.004, 0.004, > 0.001 respectively). CONCLUSION: The study concluded that oxidative stress was common finding in hemodialysis pediatric patients which may play a role in complications encountered among these patients

siRNA blocking of mammalian target of rapamycin (mTOR) attenuates pathology in annonacin-induced tauopathy in mice

Tauopathy is a pathological hallmark of many neurodegenerative diseases. It is characterized by abnormal aggregates of pathological phosphotau and somatodendritic redistribution. One suggested strategy for treating tauopathy is to stimulate autophagy, hence, getting rid of these pathological protein aggregates. One key controller of autophagy is mTOR. Since stimulation of mTOR leads to inhibition of autophagy, inhibitors of mTOR will cause stimulation of autophagy process. In this report, tauopathy was induced in mice using annonacin. Blocking of mTOR was achieved through stereotaxic injection of siRNA against mTOR. The behavioral and immunohistochemical evaluation revealed the development of tauopathy model as proven by deterioration of behavioral performance in open field test and significant tau aggregates in annonacin-treated mice. Blocking of mTOR revealed significant clearance of tau aggregates in the injected side; however, tau expression was not affected by mTOR blockage

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

Cardiac troponin I as a cardiac biomarker has prognostic and predictive value for poor survival in Egyptian buffalo calves with foot-and-mouth disease

Background and Aim: Foot-and-mouth disease (FMD) causes huge economic losses in Egypt due to reductions in the production of red meat, milk, and milk by-products and can also lead to myocarditis in young animals. The aim of our study was to evaluate cardiac biomarkers, in particular cardiac troponin I (cTnI), and to reveal the relations of cardiac biomarkers with poor survival in FMD-infected Egyptian buffalo calves. Materials and Methods: Forty-two Egyptian buffalo calves were included in this study. The calves were divided into 12 apparently healthy control calves and 30 calves clinically diagnosed with FMD during a disease outbreak in Menofia and Behera Governorates, Egypt. The diseased calves were divided, according to age, into 13 calves <3 months old and 17 calves between 3 and 6 months old. The animals were examined clinically and subjected to analysis of cardiac biomarkers. Results: Biochemical analysis revealed significant elevations of cardiac biomarkers, especially creatine kinase myocardial band (CK-MB), lactate dehydrogenase (LDH), alanine aminotransferase (ALT), aspartate aminotransferase (AST), cardiac troponin T (cTnT), and cardiac troponin I (cTnI) in FMD-infected calves in comparison with control calves. There was a significant association between cTnI and poor survival in infected calves. Conclusion: Cardiac biomarkers could be used as a rapid method for diagnosis of myocarditis induced by FMD in Egyptian buffalo calves. In addition, cTnI is a very sensitive and accurate tool for determining myocardial cell damage in the earlier stages of the disease and a good predictor of poor survival in calves

Role of sleep endoscopy in obstructive sleep apnea syndrome

Aim: There are limited data about the role of sleep endoscopy in obstructive sleep apnea syndrome (OSAS). The aim of this study was to evaluate the level, degree and shape of obstruction of the upper airway in patients with OSAS by sleep endoscopy and their relation to OSAS severity. Patients and methods: Fifty consecutive patients with OSAS were prospectively enrolled in this cross sectional analytic study. All patients underwent history, a full night-attended polysomnography and sleep endoscopy. The degree of pharyngeal narrowing (grades I–IV) was evaluated at retropalatal, retroglossal and hypopharyngeal levels. Shape of pharyngeal collapse was classified into circular, lateral or antero-posterior at retropalatal and retroglossal levels. Shape of the epiglottis was also observed. Results: All patients showed multisegmental levels of obstruction. Moderate OSAS had a higher percentage of grade II obstruction but a lower percentage of grade I at hypopharyngeal level compared to mild OSAS (P < 0.05). Also, in moderate OSAS, tongue base obstruction was 47.4% which was significantly higher comparing to mild OSAS (16.7%) (P < 0.05). There was no significant difference between different grades of obstruction at all anatomical levels in polysomnographic parameters. Omega shaped epiglottis was associated with the highest apnea hypopnea index, desaturation index, lowest average and minimum O2 level. Conclusion: Sleep endoscopy is a useful tool for the assessment of level, degree and shape of the upper airway obstruction during sleep in OSAS and this could be helpful in preoperative evaluation. Presence of obstruction at hypopharyngeal level or tongue base obstruction is an indicator of OSAS severity

Polyamide Electrospun Nanofibers Functionalized with Silica and Titanium Dioxide Nanoparticles for Efficient Dye Removal

In this work, novel multifunctional electrospun nanofibrous membranes made of polyamide (PA6) and loaded with silica (SiO2) and/or titanium dioxide (TiO2) nanoparticles were fabricated. SiO2 NPs were first prepared and then characterized by TEM, FE-SEM, and FTIR, and by using XRD techniques, confirming the formation of cristobalite tetragonal crystals with high purity. Different nanofibrous mats, loaded with SiO2 NPs, TiO2 NPs, or both SiO2 and TiO2 NPs, were investigated. Morphological studies indicated that SiO2 and TiO2 nanoparticles tend to be arranged along the fiber surface, also promoting the formation of anatase nanorods when they are mixed into the nanofibers. In this last scenario, mechanical tests have demonstrated that the presence of SiO2 contributed to balancing the mechanical response of fibers that are negatively affected by the presence of TiO2 NPs—as confirmed by tensile tests. More interestingly, the presence of SiO2 did not negatively affect the antibacterial response against different bacteria populations (i.e., Escherichia coli, Klebsiella pneumonia, Staphylococcus aureus, Bacillus subtilis, and Candida albicans), which is mainly ascribable to the presence of TiO2 particles. Accordingly, the TiO2- and TiO2/SiO2-loaded fibers showed higher methylene blue (MB) absorption values—i.e., 26 mg/g and 27 mg/g—respectively, compared to the SiO2-loaded fibers (23 mg/g), with kinetics in good agreement with the second-order kinetic model. The obtained findings pave the way for the formation of novel antibacterial membranes with a promising use in water purification

Cardiovascular Abnormalities in Egyptian Children with Mucopolysaccharidoses

The Mucopolysaccharidoses (MPS) are rare inherited metabolic disorders. They are characterized by the progressive systemic deposition of Glycosaminoglycans (GAGs). GAGs accumulate in the myocardium and the cardiac valves. Enzyme Replacement Therapy (ERT) is available for MPS I, II, and VI. However, ERT does not appear to improve cardiac valve disease in patients with valve disease present at the start of ERT.status: publishe

Significance of OCT3/4 and SOX2 antigens expression by leukemic blast cells in adult acute leukemia

Abstract Objective This study aimed to address the prognostic impact of SOX2 and OCT3/4 expression on adult acute leukemia patients’ outcomes. Methods SOX2 and OCT3/4 expression by blast cells were evaluated by flow cytometry in 80 acute leukemia patients and 8 healthy controls. Results Baseline SOX2 and OCT3/4 expression were significantly higher in both ALL (P = < 0.001, P = 0.005 respectively) and AML patients (P < 0.001, P = 0.003 respectively) as compared to control, and decline at complete remission (CR) and elevated again at relapse. High SOX2 and OCT3/4 levels were significantly correlated with the presence of adverse risk stratification parameters. Conclusion Our findings indicated that both SOX2 and OCT3/4 could serve as biomarkers that could improve risk stratification of acute leukemia patients. Also, both SOX2 and OCT3/4 might be a therapeutic target, especially in resistant acute leukemia